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 |
| Medicare Fee Schedule | View Medicare rates for 46707 |
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 | $1825.00 | 1225123227 - COMPREHENSIVE PAIN MANAGEMENT CENTER, INC. | 770533953 - (CA) COMPREHENSIVE PAIN MANAGEMENT CENTER, INC. | CA | 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 | $1980.00 | 1346220183 - BLACK HILLS REGIONAL EYE SURGERY CENTER, LLC | 460462601 - (SD) BLACK HILLS REGIONAL EYE SURGERY CENTER LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $4143.10 | 1609343052 - ADVANCED MEDICAL IMAGING SURGERY CENTER, LLC | 831444320 - (NE) ADVANCED MEDICAL IMAGING SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $2101.00 | 1437191731 - EL DORADO SURGERY CENTER LP, TUCSON SURGERY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1350.00 | 1336104926 - ATLANTA SURGERY CENTER LTD | 742452953 - (GA) ATLANTA SURGERY CENTER LTD | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1331.00 | 1811345267 - CAROLINAS AMBULATORY SURGERY INC., ATRIUM HEALTH SURGERY CENTER ROCK HILL | 812714217 - (SC) CAROLINAS AMBULATORY SURGERY INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1387.00 | 1982105458 - HEART CARE CENTER, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1544.40 | 1821066200 - LOWCOUNTRY OUTPATIENT SURGERY CENTER, LLC | 161634976 - (SC) LOWCOUNTRY OUTPATIENT SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $2585.00 | 1861766016 - HAYS SURGERY CENTER, LLC | 274579547 - (TX) HAYS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1783.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $2855.00 | 1114549805 - BSC 1 LLC | 851036387 - (AZ) BSC 1 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $4140.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $1854.00 | 1811947062 - WACO GASTROENTEROLOGY ENDOSCOPY CENTER LLC, WACO GASTROENTEROLOGY ENDOSCOPY CENTER | 43636953 - (TX) WACO GASTROENTEROLOGY ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46707 | $3570.00 | 1356621239 - MIDLAND TEXAS SURGICAL CENTER, LLC, TEXAS SURGICAL CENTER, AN AFFILIATE OF MIDLAND MEMORIAL HOSPITAL | 453047741 | TX | 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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