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 |
| CMS | $1,947.91 Physician Fee Schedule |
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 | $16050.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $581.00 | 1992384739 - SURGERY CENTER OPERATIONS, LLC | 851921698 - (FL) SURGERY CENTER OPERATIONS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $296.00 | 1356463913 - MODESTO SURGERY CENTER LLC | 770394007 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $644.00 | 1699054098 - SURGCENTER OF WESTERN MARYLAND, LLC | 272969860 - (MD) SURGCENTER OF WESTERN MARYLAND, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $650.00 | 1114912102 - BOISE ENDOSCOPY CENTER, LLC | 820506078 - (ID) BOISE ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $371.00 | 1891295275 - FRESENIUS VASCULAR CARE MONTGOMERY ASC LLC | 815391782 - (AL) FRESENIUS VASCULAR CARE MONTGOMERY ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $695.00 | 1093736795 - HATTIESBURG CLINIC PA, AMBULATORY SURGERY CENTER | 640507572 - HATTIESBURG CLINIC, P.A. | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $475.00 | 1871926428 - CHILDREN 1ST HOUSTON SOUTH, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 320417239 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $568.00 | 1679149330 - ADVANCED SURGICAL CARE OF MARYLAND, LLC | 861991275 - (MD) ADVANCED SURGICAL CARE OF MARYLAND LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $384.00 | 1750612446 - BAY SURGERY CENTERS, CLEARWAY SURGERY CENTER OF GLEN BURNIE | 271271303 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $1416.00 | 1417286428 - ALLIANCE SURGICAL CENTER LLC | 271367127 - (FL) ALLIANCE SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $715.00 | 1750528717 - ROUND ROCK SURGERY CENTER LLC, ADVANCED SURGICAL CENTER - ROUND ROCK | 260856139 - (TX) ROUND ROCK SURGERY CENTER LLC | TX | 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 | $653.00 | 1609949551 - NORTHWEST VISION INSTITUTE, PLLC, NORTHWEST LASER AND SURGERY CENTER | 383807987 - (WA) NORTHWEST VISION INSTITUTE, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46730 | $660.00 | 1912423633 - NWO SURGERY CENTER LLC | 821773714 - (OH) NWO SURGERY CENTER LLC | OH | 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 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 46730) and we'll show you how you compare in 15 minutes or less.