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See a sample rate comparisonCPT 46716 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.
Rpair Of Low Imperforat Anus; W/ Transposi Of Anoperineal Or A, Repair Of Low Imperforate Anus; With Transposition Of Anoperineal Or A
| 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 80 - Assistant surgeon 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46716 |
| Medicaid Fee Schedule | View Medicaid rates for 46716 |
National average reimbursement for CPT 46716 by major payers:
$1,448.69
$1,562.98
$1,689.92
$1,920.19
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CPT 46716
5 of 25 sample ratesHigher to lower in this preview
Whitehall Surgery Center, Ltd, Pickerington Surgery Center
$13,332.00Published rateEl Dorado Surgery Center Lp, Tucson Endoscopy Center
$1,420.00Published rateInfirmary Asc
$970.00Published rateRenal Intervention Center, LLC
Renal Intervention Center LLC
$491.00Published rateWest Shore Endoscopy Center LLC
$200.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 46707-CPT | Moderate | Repair Anal/Rectal Fistula, Procedure To Repair An Abnormal Passageway (Fistula) Starting From The Anus Or Rectum. The Repair Is Done With A Plug Device. |
| 46715-CPT | Moderate | Rpair Of Low Imperforat Anus; W/ Anoperineal Fistula (Cut-Bck Pro, Repair Of Low Imperforate Anus; With Anoperineal Fistula (Cut-Back Pro |
| 46716-CPT | High | Rpair Of Low Imperforat Anus; W/ Transposi Of Anoperineal Or A, Repair Of Low Imperforate Anus; With Transposition Of Anoperineal Or A |
| 46922-CPT | Moderate | Excision Of Anal Lesion S, Destruction Of Lesion S Anus Eg Condyloma Papilloma Molluscum Contagiosum Herpetic Vesicle Simple Surgical Excision |
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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