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See a sample rate comparisonCPT 46612 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Anoscopy Remove Lesions, Anoscopy With Removal Of Multiple Tumors Polyps Or Other Lesions By Hot Biopsy Forceps Bipolar Cautery Or Snare Technique
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46612 |
| Medicaid Fee Schedule | View Medicaid rates for 46612 |
National average reimbursement for CPT 46612 by major payers:
$348.39
$382.68
$428.87
$175.12
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CPT 46612
5 of 25 sample ratesHigher to lower in this preview
Presbyterian Sameday Surgery Center At Ballantyne LLC, Novant Health Ballantyne Outpatient Surgery
$4,825.00Published ratePioneer Valley Surgicenter LLC, Pioneer Valley Surgicenter
Pioneer Valley Surgicenter, LLC
$2,323.00Published rateGastro Operating Company LLC, (Dba) Meadowbrook Endoscopy Center
Gastro Operating Company, LLC
$1,535.00Published rateBay Surgery Centers LLC
$920.00Published rateTanaporn Rasameesoraj
Deaconess Hospital Inc
$508.83Published rate
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See a sample payer proposalCPT 46612 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46612 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 46612 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 46601-CPT | Moderate | Diagnostic Anoscopy, Anoscopy Diagnostic With High Resolution Magnification Hra Eg Colposcope Operating Microscope And Chemical Agent Enhancement Including Collection Of Specimen S By Brushing Or Washing When Performed |
| 46604-CPT | Moderate | Exam Of Anus With Scope, Examination Of The Anus Using A Scope To View The Anal Canal. The Procedure Includes Widening Of The Anal Canal. |
| 46606-CPT | Moderate | Rectal Exam With Scope, An Exam Of The Anus And Rectum Using A Scope (Anoscopy). The Procedure May Take A Sample Of Tissue For Testing (Biopsy). |
| 46612-CPT | Moderate | Anoscopy Remove Lesions, Anoscopy With Removal Of Multiple Tumors Polyps Or Other Lesions By Hot Biopsy Forceps Bipolar Cautery Or Snare Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46612 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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