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See a sample rate comparisonCPT 46730 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.
Construction Of Absent Anus, Repair Of Absence Of Opening In Anus Via Incision Of Region Between Thighs Or Below Sacrum (Perineal Or Sacroperineal Approach)
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 46730 |
National average reimbursement for CPT 46730 by major payers:
$2,400.40
$2,534.14
$2,661.03
$3,088.96
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CPT 46730
5 of 25 sample ratesHigher to lower in this preview
Burlington County Endoscopy Center LLC
$4,300.00Published rateMichigan Endoscopy Center LLC
$1,028.00Published rateEast Brunswick Surgery Center LLC, University Surgicenter
East Brunswick Surgery Center
$679.00Published rateBay Microsurgical Unit
$459.00Published ratePerlow Facility, LLC
Perlow Facility LLC
$215.00Published rate
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See a sample payer proposalCPT 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 | Rpair Of Low Imperforat Anus; W/ Anoperineal Fistula (Cut-Bck Pro, Repair Of Low Imperforate Anus; With Anoperineal Fistula (Cut-Back Pro |
| 46730-CPT | High | Construction Of Absent Anus, Repair Of Absence Of Opening In Anus Via Incision Of Region Between Thighs Or Below Sacrum (Perineal Or Sacroperineal Approach) |
| 46735-CPT | High | Construction Of Absent Anus, Repair Of Absence Of Opening In Anus Via Incision Of Abdomen And Region Between Thighs And Below Sacrum (Combined Abdominal And Sacroperineal Approach) |
| 46940-CPT | Moderate | Curettage Or Cauterization Of, Curettage Or Cauterization Of Anal Fissure Includingdilation Of Anal Sphincter (Separate Procedure) Initial |
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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