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See a sample rate comparisonCPT 46712 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repr Per/Vag Pouch Dbl Proc, Repair Of Abnormal Drainage Tract Or Pocket From Surgically Created Of Small Intestinal Reservoir For Feces Via Incision Of Abdomen And Region Between Thighs (Combined Abdominoperineal Approach)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AG - Primary physician 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46712 |
| Medicaid Fee Schedule | View Medicaid rates for 46712 |
National average reimbursement for CPT 46712 by major payers:
$2,737.25
$2,913.83
$3,068.65
$3,503.16
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CPT 46712
5 of 25 sample ratesHigher to lower in this preview
Voorhees Nj Endoscopy Asc LLC, The Endo Center At Voorhees
The Voorhees Nj Endoscopy Asc LLC
$4,825.00Published rateMid-Bronx Endoscopy Center LLC
Midbronx Endoscopy Center LLC
$1,114.00Published rateCentral Virginia Surgi-Center Lp, Surgi-Center Of Central Virginia
Central Virginia Surgicenter Lp
$1,028.00Published rateGreenbrier Clinic Surgery Center
$567.00Published rateCentral Arizona Endoscopy LLC
$97.00Published rate
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See a sample payer proposalCPT 46712 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46712 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 46712 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 |
|---|---|---|
| 46710-CPT | High | Repr Per/Vag Pouch Sngl Proc, Repair Of Abnormal Drainage Tract Or Pocket From Surgically Created Of Small Intestinal Reservoir For Feces Via Incision Of Region Between Thighs (Combined Abdominoperineal Approach) |
| 46712-CPT | High | Repr Per/Vag Pouch Dbl Proc, Repair Of Abnormal Drainage Tract Or Pocket From Surgically Created Of Small Intestinal Reservoir For Feces Via Incision Of Abdomen And Region Between Thighs (Combined Abdominoperineal Approach) |
| 46945-CPT | Moderate | Int Hrhc Lig 1 Hroid W O Img, Hemorrhoidectomy Internal By Ligation Other Than Rubber Band Single Hemorrhoid Column Group Without Imaging Guidance |
| 47100-CPT | High | Biopsy Liver Wedge |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46712. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46712 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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