CPT 46700 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $642.73 Physician Fee Schedule |
National average reimbursement for CPT 46700 by major payers:
$815.51
$856.43
$887.32
$1,074.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 46700 | ||||||
United | 46700 | $1503.00 | 1649944521 - PRECISION BONE AND JOINT SURGERY CENTER | 861302912 - (FL) PRECISION BONE AND JOINT SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $4617.00 | 1336695188 - HHC HARTFORD SURGERY CENTER, LLC | 812637261 - (CT) HHC HARTFORD SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1954.00 | 1437764321 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT PLANTATION | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1285.00 | 1003889379 - THE WALDORF ENDOSCOPY ASC, LLC, WALDORF ENDOSCOPY CENTER | 621806186 - (MD) THE WALDORF ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $2388.00 | 1295324721 - UROLOGY ASC- PHOENIX, LLC, UROLOGIC SURGERY CENTER OF ARIZONA | 320586987 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1040.00 | 1689311938 - HURON GASTRO ENDOSCOPY CENTER LLC, HURON GASTRO CENTER FOR DIGESTIVE CARE | 853580801 - (MI) HURON GASTRO ENDOSCOPY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $2353.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1400.00 | 1154593481 - RANCHO MIRAGE SURGERY CENTER, LLC, RANCHO MIRAGE SURGERY CENTER | 262136928 - (CA) RANCHO MIRAGE SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $380.00 | 1265434740 - SALLY K BALIN AMBULATORY SURGICAL CENTER INC | 232969046 - (PA) SALLY K BALIN AMBULATORY SURGICAL CENTER INC. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $2990.00 | 1831576891 - ADVANCED SURGERY CENTER PERIMETER, LLC | 473080613 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1180.00 | 1942455449 - HEA GRAMERCY SURGERY CENTER, PLLC, HEA SURGERY CENTER | 263722257 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1284.00 | 1619525912 - SUMMIT SURGERY CENTER MODESTO, INC | 842546051 - (CA) SUMMIT SURGERY CENTER MODESTO INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $3625.00 | 1164458634 - SAINT FRANCIS SURGERY CENTER, LLC, SAINT FRANCIS SURGERY CENTER | 61641562 - (TN) SAINT FRANCIS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1700.00 | 1124484019 - EDISON SURGERY CENTER LLC | 475016492 - (NJ) EDISON SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46700 | $1600.00 | 1700424322 - GEORGIA INTERVENTIONAL PAIN | 841727755 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 46700 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46700 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 46700 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 |
|---|---|---|
| 46600-CPT | Low | Anoscopy; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed(Separate Procedure) (Desc Revised 01/01/15) |
| 46615-CPT | Moderate | Anoscopy; With Ablation Of Tumor(S), Polyp(S), Or Other Lesion(S) Not Amenable To Removal By Hot Biopsy Forceps, Bipolar Cautery Or Snare Technique |
| 46700-CPT | Moderate | Anoplasty For Stricture Adult |
| 46705-CPT | Moderate | Anoplasty,Plas.Op-Stricture;Infant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46700. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46700 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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