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CPT 46751 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Sphincteroplasty Anal Child
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

23 - Emergency Room

Common Modifiers

None

58 - Staged or related procedure during postoperative period

51 - Multiple procedures

80 - Assistant surgeon

AG - Primary physician

GC - Service performed by resident under supervision

Complexity LevelModerate
CMS$660.19 Physician Fee Schedule

National average reimbursement for CPT 46751 by major payers:

bcbs

$810.82

uhc

$854.13

aetna

$896.79

cigna

$1,072.47

Preview provider-level rates for...
For billing codeCPT 46751
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 46751

United
46751$983.001235146325 - WEBSTER AMBULATORY SURGERY CENTER LP, WEBSTER SURGERY CENTER205953387MOAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$684.001467442657 - HOLY REDEEMER AMBULATORY SURGERY CENTER, LLC233020527 - (PA) HOLY REDEEMER AMBULATORY SURGERY CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$570.001801323191 - NS SURGICAL CENTER LLC814954399 - (KS) NS SURGICAL CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$679.001063593952 - CONNECTICUT GI ENDOSCOPY CENTER LLC61573358 - (CT) CONNECTICUT GI ENDOSCOPY CENTER LLCCTAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$773.001164534400 - MISSION HILLS SURGICENTER, LLC, MISSION HILLS PAIN TREATMENT CENTER203206715CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$350.001386833044 - THE POTTSVILLE PA ENDOSCOPY ASC LP, SCHUYLKILL ENDOSCOPY CENTER260303896PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$650.001730153073 - EAST MEMPHIS UROLOGY CENTER, LP, UROCENTER621810940 - (TN) EAST MEMPHIS UROLOGY CENTER LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$1064.001770180986 - AUDUBON AMBULATORY SURGERY CENTER LLC, AUDUBON ASC AT ST. FRANCIS841482638 - (CO) AUDUBON AMBULATORY SURGERY CENTER, LLC.COAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$828.001720398167 - CROSSTOWN SURGERY CENTER LLC272552748MNAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$300.001023039195 - CAPE SURGERY CENTER, LLC200649544 - (TN) CAPE SURGERY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$475.001831283860 - THE COOKEVILLE SURGERY CENTER621366678 - (TN) THE COOKEVILLE SURGERY CENTERTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$335.001326084740 - ENDOSCOPY CENTER OF SW VA900165230 - (VA) ENDOSCOPY CENTER OF SW VAVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$867.001841858735 - ELITE AMBULATORY SURGERY CENTER, LLC841973218MOAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$983.001659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$461.001306214705 - GSI ASC, LLC474883816 - (OK) GSI ASC LLCOKAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 46751 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 46751 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 46751 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.

CodeComplexityDescription
46750-CPTModerateSphincteropl,Anal-Prolapse;Adult
46751-CPTModerateSphincteroplasty Anal Child
46753-CPTModerateGraft-Rectal Incontinence/Prolpse
46760-CPTHighSphincteropl,Anal,Adult;Musc Txplnt

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46751. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 46751 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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