CPT 46735 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 • 79 - Unrelated procedure - postop period • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46735 |
National average reimbursement for CPT 46735 by major payers:
$2,716.81
$2,926.14
$3,056.48
$3,625.67
| 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 46735 | ||||||
United | 46735 | $315.00 | 1720081664 - HEATON LASER AND SURGERY CENTER L L C | 752752100 - (TX) HEATON LASER AND SURGERY CENTER L L C | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $530.00 | 1861470486 - ORLAND PARK SURGICAL CENTER LLC | 364418271 - (IL) ORLAND PARK SURGICAL CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $1028.00 | 1063092047 - TAMPA BAY JOINT AND SPINE, LLC, TAMPA BAY JOINT AND SPINE SURGERY CENTER | 851259146 - (FL) TAMPA BAY JOINT AND SPINE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $408.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $2652.00 | 1275596264 - CAROLINA REGIONAL SURGERY CENTER. LTD | 621616402 - (SC) CAROLINA REGIONAL SURGERY CENTER LTD | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $375.00 | 1740876671 - FRESENIUS VASCULAR CARE DAYTON ASC LLC | 852997056 - (OH) FRESENIUS VASCULAR CARE DAYTON ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $620.00 | 1184897472 - LAKE COUNTRY ENDOSCOPY CENTER, LLC | 261572986 - (WI) LAKE COUNTRY ENDOSCOPY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $2172.00 | 1043708019 - OAK POINT SURGICAL SUITES LLC | 823437812 - (TX) OAK POINT SURGICAL SUITES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $494.00 | 1629173075 - THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN, PLLC, CROWNE POINT ENDOSCOPY & SURGERY CENTER | 352227535 - (MI) THE DIGESTIVE ENDOSCOPY CENTER OF MICHIGAN PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $628.00 | 1235105248 - GURLEY SURGERY CENTER, THE GYN CENTER | 621159796 - (TN) GURLEY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $347.00 | 1154538544 - COLLIER ENDOSCOPY & SURGERY CENTER | 651093702 - (FL) COLLIER ENDOSCOPY SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $1732.00 | 1841920683 - ENDOSCOPY CENTER OF BEVERLY HILLS LLC | 872038458 - ENDOSCOPY CENTER OF BEVERLY HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $555.00 | 1780117440 - INSIGHT SURGERY CENTER, LLC | 813772336 - (CO) INSIGHT SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $6659.00 | 1326286360 - NORTH CAMPUS SURGERY CENTER LLC | 352147088 - (IN) NORTH CAMPUS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $600.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | 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 46735 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46735 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 46735 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 |
|---|---|---|
| 46730-CPT | High | Construct Anus Perineal/Sacrococcyg |
| 46735-CPT | High | Construct Anus-Absnc;Abd/Perin Appc |
| 46740-CPT | High | Repair Of Absence Of Opening In Anus And Abnormal Opening From Rectum Into Urethra Or Vagina Through Region Between Thighs Or Below Sacrum |
| 46910-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Electrodesiccation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46735. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46735 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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