CPT 46707 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 • 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| CMS | $499.43 Physician Fee Schedule |
National average reimbursement for CPT 46707 by major payers:
$619.94
$657.50
$676.25
$836.67
| 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 46707 | ||||||
United | 46707 | $7166.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $4500.00 | 1386748440 - COAST CENTER FOR ORTHOPEDIC AND ARTHROSCOPIC SURGERY LLC, SHARP SAN DIEGO SURGERY CENTER | 330839637 - (CA) COAST CENTER FOR ORTHOPEDIC AND ARTHROSCOPIC SURGERY, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $3353.00 | 1891745956 - NORTH SUBURBAN SPINE CENTER LP, NORTH METRO SURGERY CENTER | 571231282 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1500.00 | 1144516451 - CPMSC GWINNETT, LLC | 274810320 - (GA) CPMSC GWINNETT LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $3350.00 | 1013136456 - SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC, ADVANCED SURGICAL INSTITUTE | 204481032 - (NJ) SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $3695.00 | 1487693123 - CLARKSVILLE SURGERY CENTER LLC | 621752518 - (TN) CLARKSVILLE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $788.00 | 1528061918 - CATARACT SPECIALTY SURGICAL CENTER, LLC, CATARACT SPECIALTY SURGICAL CENTER | 200225369 - (MI) CATARACT SPECIALTY SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $4339.00 | 1588867030 - PACIFIC ENDO-SURGICAL CENTER LP | 562387275 - (CA) PACIFIC ENDOSURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $3989.00 | 1861825986 - VADNAIS HEIGHTS SURGERY CENTER LLC, VADNAIS HEIGHTS SURGERY CENTER | 371866891 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1030.00 | 1720227176 - ST. AGNES HEALTHCARE, INC., GEORGE THOMAS GRACE M.D. SURGERY CENTER | 520591657 - ST AGNES HEALTHCARE INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1914.00 | 1295207579 - AGHAPY SURGICAL CENTER SC | 825243001 - (IL) AGHAPY SURGICAL CENTER SC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $2129.00 | 1225377278 - CENTER FOR MINIMALLY INVASIVE SURGERY PLLC, SOUNDVIEW AMBULATORY SURGERY CENTER | 911661866 - (WA) CENTER FOR MINIMALLY INVASIVE SURGERY, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $12000.00 | 1750071007 - DISC SURGERY CENTER AT MARINA DEL REY LLC | 880601479 - (CA) DISC SURGERY CENTER AT MARINA DEL REY LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $808.00 | 1902079775 - ORLANDO MILLS FL ENDOSCOPY ASC LLC, CENTER FOR DIGESTIVE ENDOSCOPY | 262277693 - (FL) ORLANDO MILLS FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $6632.00 | 1497352934 - LEXINGTON HEALTH INC, LMC LEXINGTON ASC | 852276567 - LEXINGTON HEALTH INC | SC | 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 46707 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46707 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 46707 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 |
|---|---|---|
| 46706-CPT | Moderate | Repair Of Anal Fistula With Fibrin Glue |
| 46707-CPT | Moderate | Repair Of Anorectal Fistula With Plug (Eg, Porcine Small Intestine Submucosa [Sis]) |
| 46716-CPT | High | Perineal Txplnt-Anovaginal Fistula |
| 46910-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Electrodesiccation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46707. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46707 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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