CPT 46730 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 • 22 - Increased Procedural Services • 62 - Co-Surgeons • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46730 |
National average reimbursement for CPT 46730 by major payers:
$2,400.40
$2,534.14
$2,661.03
$3,156.78
| 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 46730 | ||||||
United | 46730 | $1686.00 | 1962676304 - 32ND STREET SURGERY CENTER, LLC | 261339811 - (MO) 32ND STREET SURGERY CENTER, L.L.C. | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $400.00 | 1750414983 - ROCKLEDGE SURGERY CENTER, INC. | 522098503 - (MD) ROCKLEDGE SURGERY CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $705.00 | 1588427991 - LAKELAND REGIONAL HEALTH SURGERY CENTER, LLC | 934616298 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $1028.00 | 1629075106 - MICHIGAN ENDOSCOPY CENTER LLC | 364469630 - (MI) MICHIGAN ENDOSCOPY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $561.00 | 1255792453 - MIDWEST EYE CONSULTANTS OHIO, INC, CATARACT & LASER INSTITUTE #351 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $358.00 | 1881736734 - MILLENIA SURGERY CENTER LLC | 562384725 - (FL) MILLENIA SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $1000.00 | 1528219474 - CLARKSTON ASC PARTNERS LLC, CLARKSTON SURGERY CENTER | 203360827 - (MI) CLARKSTON ASC PARTNERS, LLC DBA CLARKSTON SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $4300.00 | 1982880274 - BURLINGTON COUNTY ENDOSCOPY CENTER LLC | 208205206 - (NJ) BURLINGTON COUNTY ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $995.00 | 1548322829 - GASTROINTESTINAL MEDICAL CENTER | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $1049.00 | 1083624670 - PRESCOTT OUTPATIENT SURGICAL CENTER LLC | 860548048 - (AZ) PRESCOTT OUTPATIENT SURGICAL CENTER, LP | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $215.00 | 1871644823 - PERLOW FACILITY, LLC | 251926011 - (GA) PERLOW FACILITY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $1064.00 | 1326453325 - CAPITAL CITY SURGERY CENTER OF FLORIDA LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $679.00 | 1093731101 - EAST BRUNSWICK SURGERY CENTER LLC, UNIVERSITY SURGICENTER | 20593133 - (NJ) EAST BRUNSWICK SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $524.00 | 1639476377 - LIVONIA OUTPATIENT SURGERY CENTER, LLC | 261322609 - (MI) LIVONIA OUTPATIENT SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $523.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | 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 |
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CPT 46730 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46730 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 46730 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 |
|---|---|---|
| 46715-CPT | Moderate | Rep Fistula Anovaginal Congenital |
| 46730-CPT | High | Construct Anus Perineal/Sacrococcyg |
| 46735-CPT | High | Construct Anus-Absnc;Abd/Perin Appc |
| 46924-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Extensive (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46730. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46730 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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