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CPT 46716 Fee Schedule

Last Verified: November 2025

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.

Perineal Txplnt-Anovaginal Fistula
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

80 - Assistant surgeon

82 - Assistant surgeon - no qualified resident

Complexity LevelHigh
CMS$1,216.88 Physician Fee Schedule

National average reimbursement for CPT 46716 by major payers:

bcbs

$1,448.69

uhc

$1,562.98

aetna

$1,689.92

cigna

$1,960.80

Preview provider-level rates for...
For billing codeCPT 46716
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 46716

United
46716$550.001295258416 - PUMPKIN PATCH AMBULATORY SURGICAL CENTER, LLC, ORLANDO AVENUE SURGERY CENTER, LLC475078896 - (FL) PUMPKIN PATCH AMBULATORY SURGICAL CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$1773.001346249604 - ST. MARY'S SURGICAL CENTER LLC, ST. MARY'S SURGICAL CENTER201685516 - (MO) ST MARYS SURGICAL CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$3025.121649748708 - ANKENY MEDICAL PARK SURGERY CENTER LC831281114 - (IA) ANKENY MEDICAL PARK SURGERY CENTER LCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$1801.001962431197 - SHAWNEE MISSION SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER SHAWNEE MISSION481243914 - (KS) SHAWNEE MISSION SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$261.001780727636 - UNION SURGERY CENTER, INC, ADVANCED ENDOSCOPY CENTER205205858 - (CA) UNION SURGERY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$2172.001508871211 - TEXAS DIGESTIVE DISEASE CENTER, LTD273578014TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$1146.001922660109 - BANNER SURGERY CENTER842157389 - (AZ) BANNER SURGERY CENTERAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$649.001104897644 - FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C., FOX VALLEY ORTHOPAEDIC AMBULATORY SURGICAL CENTER362796281 - FOX VALLEY ORTHOPAEDIC ASSOCIATES, S.C.ILAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$852.001609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$850.001295233658 - LEGENT OUTPATIENT SURGERY WESTOVER HILLS, LLC823717201TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$475.001497723720 - JACKSONVILLE BEACH SURGERY CENTER, LLC, JACKSONVILLE BEACH SURGERY CENTER621825684 - (FL) JACKSONVILLE BEACH SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$362.001922262278 - EPS SURGICAL CENTER, LLC260875908 - (GA) EPS SURGICAL CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$460.001649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUSLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$440.001518264332 - SANTA FE SURGERY CENTER LLC272869086 - (FL) SANTA FE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$1366.001154840064 - SOUTHHEALTH ASC, LLC, EDINA SPECIALTY SURGERY CENTER822364607 - (MN) SOUTHHEALTH ASC LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 46716 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 46716 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 46716 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.

CodeComplexityDescription
46707-CPTModerateRepair Of Anorectal Fistula With Plug (Eg, Porcine Small Intestine Submucosa [Sis])
46715-CPTModerateRep Fistula Anovaginal Congenital
46716-CPTHighPerineal Txplnt-Anovaginal Fistula
46730-CPTHighConstruct Anus Perineal/Sacrococcyg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46716. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 46716 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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