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CPT 46716 Fee Schedule

Last Verified: January 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.

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
Medicare Fee ScheduleView Medicare rates for 46716

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$299.001578077103 - SNNAC LLC, AZURA SURGERY CENTER NORTHERN NEVADA821669704 - (NV) SNNAC LLCNVAmbulatory 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$273.001164734232 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC272910652 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$13332.001679577167 - WHITEHALL SURGERY CENTER, LTD, PICKERINGTON SURGERY CENTER311479613OHAmbulatory 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$2737.001174591143 - SILICON VALLEY SURGERY CENTER, LP770495522 - (CA) SILICON VALLEY SURGERY CENTER, L.P.CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$470.001215919329 - GASTRO-INTESTINAL CENTER INC710676674 - (AR) GASTROINTESTINAL CENTER INCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$970.001093461410 - INFIRMARY ASC871933440 - (AL) INFIRMARY ASCALAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$2302.001871912485 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, SOUTH DENVER ENDOSCOPY CENTER800688043COAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$1049.001730713439 - FLORIDA SPRINGS SURGERY CENTER LLC832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER LFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$2444.001609907211 - SHREWSBURY SURGERY CENTER, LLC, SHREWSBURY SURGERY CENTER223651945 - (NJ) SHREWSBURY SURGERY CENTER LLCNJAmbulatory 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$200.001326047937 - WEST SHORE ENDOSCOPY CENTER LLC251885828 - (PA) WEST SHORE ENDOSCOPY CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$491.001639242506 - RENAL INTERVENTION CENTER, LLC371387622 - (IL) RENAL INTERVENTION CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
46716$991.001154318103 - OPTUM CARE WASHINGTON PLLC, OPTUM - KEMP SURGERY CENTER910214500 - THE EVERETT CLINIC, PLLCWAAmbulatory 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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