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See a sample rate comparisonCPT 46740 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 And Abnormal Opening From Rectum Into Urethra Or Vagina Approached Through 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 80 - Assistant surgeon 82 - Assistant surgeon - no qualified resident 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46740 |
| Medicaid Fee Schedule | View Medicaid rates for 46740 |
National average reimbursement for CPT 46740 by major payers:
$2,548.53
$2,805.68
$2,955.71
$3,395.16
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CPT 46740
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Katy LLP
$5,554.00Published rateTlc Asc, LLC, Kzmss Again, Lllp
Tlc Asc LLC
$1,028.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$565.00Published rateSurgery Center 121 LLC
$390.00Published rateBerks Center For Digestive Health, Lp
$212.00Published rate
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See a sample payer proposalCPT 46740 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46740 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 46740 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 |
|---|---|---|
| 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) |
| 46742-CPT | High | Epair Of Imperforated Anus, Repair Of Absence Of Opening In Anus And Abnormal Opening From Rectum Into Urethra Or Vagina Approached Through Abdomen Or 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 |
| 46942-CPT | Moderate | Curettage Or Cauterization Of, Curettage Or Cauterization Of Anal Fissure Includingdilation Of Anal Sphincter (Separate Procedure) Subsequent |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46740. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46740 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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