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 |
| CMS | $2,238.38 Physician Fee Schedule |
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 | $2172.00 | 1043708019 - OAK POINT SURGICAL SUITES LLC | 823437812 - (TX) OAK POINT SURGICAL SUITES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $1500.00 | 1437794625 - VANCE THOMPSON VISION SURGERY CENTER BILLINGS, LLC | 455323939 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $345.00 | 1801961313 - PRINCETON EYE GROUP PA, EYE SURGERY PRINCETON | 222361560 - (NJ) PRINCETON EYE GROUP | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $450.00 | 1578094462 - AMERICAN ACCESS CARE OF JACKSONVILLE ASC LLC, AZURA SURGERY CENTER JACKSONVILLE | 814635841 - (FL) AMERICAN ACCESS CARE OF JACKSONVILLE ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $983.00 | 1003813221 - UNIVERSITY SURGERY CENTER LTD | 742894406 - (FL) UNIVERSITY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $1600.00 | 1265431670 - AUBURN SURGERY CENTER INC. | 431937843 - (MO) AUBURN SURGERY CENTER INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $523.00 | 1215410592 - ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC | 830957221 - (GA) ALLIANCE SURGERY CENTER AT WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $420.00 | 1043396245 - WEST FLORIDA MEDICAL CENTER CLINIC PA, MEDICAL CENTER CLINIC AMBULATORY SURGICAL CENTER | 592193856 - (FL) WEST FLORIDA MEDICAL CENTER CLINIC, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $600.00 | 1619517539 - MOUNTAIN WEST DERM | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $724.00 | 1194790808 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $845.00 | 1689863771 - CAROLINA SURGERY CENTER LLC, THE SURGERY CENTER AT EDGEWATER | 200707167 - (SC) CAROLINA SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $1604.00 | 1689635757 - ATLANTICARE SURGERY CENTER LLC | 223265214 - ATLANTICARE HEALTH SYSTEM INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $6500.00 | 1437459617 - UNION HEALTH SERVICES, LLC, ATRIUM HEALTH SURGERY CENTER INDIAN TRAIL | 300597871 - (NC) UNION HEALTH SERVICES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $722.00 | 1013980317 - LOS ANGELES-INGLEWOOD ENDOSCOPY LP, AIRPORT ENDOSCOPY CENTER | 621814135 - (CA) LOS ANGELESINGLEWOOD ENDOSCOPY LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46735 | $500.00 | 1629175062 - SARATOGA SCHENECTADY ENDOSCOPY CENTER, LLC | 550867698 - (NY) SARATOGA SCHENECTADY ENDOSCOPY CENTER LLC | NY | 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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