CPT 46712 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 46712 by major payers:
$2,737.25
$2,913.83
$3,068.65
$3,582.18
| 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 46712 | ||||||
United | 46712 | $551.00 | 1063514107 - OHIO SURGERY CENTER LLC | 870566551 - (OH) OHIO SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $376.00 | 1740413400 - ATLANTIC SURGERY & LASER CENTER LLC | 262041000 - (FL) ATLANTIC SURGERY LASER CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $936.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $600.00 | 1619920501 - CENTER FOR DIGESTIVE HEALTH | 364532301 - (IL) THE CENTER FOR DIGESTIVE HEALTH, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $775.00 | 1922625995 - NATIONAL SURGICAL CENTERS STOCKTON, LLC | 842979070 - (CA) NATIONAL SURGICAL CENTERS STOCKT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $969.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $567.00 | 1174713382 - GREENBRIER CLINIC SURGERY CENTER | 200126880 | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $97.00 | 1750312435 - CENTRAL ARIZONA ENDOSCOPY LLC | 203643513 - (AZ) CENTRAL ARIZONA ENDOSCOPY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $1028.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $1028.00 | 1043605934 - SEASIDE SURGERY CENTER, LLC | 472399984 - (FL) SEASIDE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $1168.00 | 1992788384 - ASPEN SURGERY VENTURE LLC, ASPEN SURGERY CENTER | 263913327 - (CA) ASPEN SURGERY VENTURE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $1114.00 | 1023551413 - MID-BRONX ENDOSCOPY CENTER LLC | 471156630 - (NY) MIDBRONX ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $2919.00 | 1619974219 - ST. JOSEPH'S SURGERY CENTER LP | 201019390 - (CA) ST JOSEPHS SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $4825.00 | 1669446852 - VOORHEES NJ ENDOSCOPY ASC LLC, THE ENDO CENTER AT VOORHEES | 510446274 - (NJ) THE VOORHEES NJ ENDOSCOPY ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46712 | $163.00 | 1932190170 - OCALA EYE SURGERY CENTER INC | 593323478 - (FL) OCALA EYE SURGERY CENTER INC | FL | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 | Repair Of Abnormal Drainage Tract Or Pocket From Surgically Created Pouch Of Small Bowel Through Incision Of Region Between Thighs |
| 46712-CPT | High | Repair Of Abnormal Drainage Tract Or Pocket From Surgically Created Pouch Of Small Bowel Through Incision Of Abdomen And Region Between Thighs |
| 46945-CPT | Moderate | Hemorrhoidectomy Internal By Ligation Other Than Rubber Band; Single Hemorrhoid Column/Group Without Imaging Guidance (Desc Rvsd 1/1/20) |
| 46946-CPT | Moderate | Hemorrhoidectomy Internal By Ligation Other Than Rubber Band; 2 Or More Hemorrhoid Columns/Groups Without Imaging Guidance (Desc Rvsd 1/1/20) |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 46712) and we'll show you how you compare in 15 minutes or less.