CPT 46746 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 |
| Common Modifiers | • None • 62 - Co-Surgeons • GC - Service performed by resident under supervision • 66 - Surgical Team |
| Complexity Level | High |
| CMS | $3,791.33 Physician Fee Schedule |
National average reimbursement for CPT 46746 by major payers:
$4,656.33
$5,071.32
$5,240.90
$6,192.63
| 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 46746 | ||||||
United | 46746 | $925.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $589.00 | 1437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC | 463556921 - (NC) PRIME SURGICAL SUITES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $2732.00 | 1659473924 - MID-AMERICA SURGERY INSTITUTE LLC | 50564556 - (KS) MIDAMERICA SURGERY INSTITUTE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $1383.00 | 1245297662 - WOODLAND SURGERY CENTER LLC | 391998961 - (WI) WOODLAND SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $1064.00 | 1649707324 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $538.00 | 1770990376 - ADVANCED VISION SURGERY CENTER LLC | 453791209 - (VA) ADVANCED VISION SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $1049.00 | 1831489335 - HAGERSTOWN SURGERY CENTER,LLC | 274935096 - (MD) HAGERSTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $1049.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $6489.00 | 1558501916 - ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC | 202256900 - (IN) ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $900.00 | 1003553645 - CYPRESS AMBULATORY SURGERY CENTER, LLC, CURRENCY CIRCLE SURGERY CENTER | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $344.00 | 1295847317 - DIGESTIVE HEALTH & ENDOSCOPY CENTER LLC | 204370189 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $700.00 | 1679605729 - METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC | 222306421 - (NJ) METROPOLITAN SURGICAL ASSOCIATES, INC. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $393.00 | 1811090350 - GREEN SURGERY CENTER LLC | 621770173 - (TN) GREEN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $4825.00 | 1861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS | 270907140 - (NJ) CENTER FOR AMBULATORY AND MINI | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46746 | $2847.00 | 1699742676 - PARKWAY SURGERY CENTER, LTD | 364581088 | OH | 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 46746 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46746 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 46746 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 |
|---|---|---|
| 46742-CPT | High | Repair Of High Imperforate Anus With Recto-Urethral Or Recto-Vaginal Fistula; Combined Trans-Abdominal & Sacro-Perineal Approaches |
| 46746-CPT | High | Repair Of Defect For Single Channel Outlet Of Rectum, Vagina, And Urinary Tract Through Abdomen And Region Between Thighs Or Below Sacrum |
| 46748-CPT | High | Repair Of Cloacal Anomaly By Anorectovaginoplasty And Urethroplasty, Combined Abdominal And Sacroperineal Approach; With Vaginal Lengthening By Intestinal Graft Or Pedicle Flaps |
| 46946-CPT | Moderate | Hemorrhoidectomy Internal By Ligation Other Than Rubber Band; 2 Or More Hemorrhoid Columns/Groups Without Imaging Guidance (Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46746. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46746 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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