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See a sample rate comparisonCPT 46735 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 Abdomen And Region Between Thighs And Below Sacrum (Combined Abdominal And 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 79 - Unrelated procedure - postop period 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46735 |
| Medicaid Fee Schedule | View Medicaid rates for 46735 |
National average reimbursement for CPT 46735 by major payers:
$2,716.81
$2,926.14
$3,056.48
$3,548.04
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CPT 46735
5 of 25 sample ratesHigher to lower in this preview
North Campus Surgery Center LLC
$6,659.00Published rateAssociated Health Services, Inc., James E Davis Ambulatory Surgical Center
Associated Health Services Inc
$1,457.00Published rateLake Country Endoscopy Center, LLC
Lake Country Endoscopy Center LLC
$620.00Published rateThe Digestive Endoscopy Center Of Michigan, PLLC, Crowne Point Endoscopy & Surgery Center
The Digestive Endoscopy Center Of Michigan PLLC
$494.00Published rateHeaton Laser And Surgery Center L L C
$315.00Published rate
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See a sample payer proposalCPT 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 | 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) |
| 46740-CPT | High | Construction Of Absent Anus, Repair Of Absence Of Opening In Anus And Abnormal Opening From Rectum Into Urethra Or Vagina Approached Through Region Between Thighs Or Below Sacrum (Perineal Or Sacroperineal Approach) |
| 46910-CPT | Moderate | Anus Surgery To Remove Growth, Surgery To Destroy And Remove Abnormal Tissue From The Anus. The Tissue May Be Destroyed With Heat Cold Chemicals Or A Laser. |
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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