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CPT 46751 Fee Schedule

Last Verified: January 2026

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
Medicare Fee ScheduleView Medicare rates for 46751

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$570.001801323191 - NS SURGICAL CENTER LLC814954399 - (KS) NS SURGICAL CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$501.001154369114 - CHRISTUS SANTA ROSA PASC-SAN ANTONIO LLC, CHRISTUS SURGERY CENTER - ALAMO HEIGHTS412092141 - (TX) CHRISTUS SRPASC - SAN ANTONIO, LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$370.001548263619 - AZAR EYE SURGERY CENTER LLC522325381 - (MD) AZAR EYE SURGERY CENTER LLCMDAmbulatory 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$695.001245399757 - KUMAR SURGICAL CENTER LLC383530839 - (MI) KUMAR SURGICAL CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$1064.001962714154 - SURGCENTER OF WHITE MARSH, LLC272873637 - (MD) SURGCENTER OF WHITE MARSH, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$2302.001851029060 - COLORADO SPRINGS SURGICENTER, LLC862813124 - COLORADO SPRINGS SURGICENTER LLCCOAmbulatory 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$2732.001275536393 - MEDICAL CENTER SURGERY ASSOCIATES, LP621449272 - (FL) MEDICAL CENTER SURGERY ASSOCIATES LPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$405.001154301240 - ENDOSCOPY CENTER OF WASHINGTON DC LP, THE ENDOSCOPY CENTER OF WASHINGTON, D.C.621543524 - (DC) ENDOSCOPY CENTER OF WASHINGTON DC LPDCAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$860.001346918646 - TIMPVIEW ASC, LLC872314348 - (UT) TIMPVIEW ASC LLCUTAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$2652.001063007573 - GEORGIA EYE SURGICENTER, LLC, GEORGIA EYE INSTITUTE SURGERY CENTER861925762GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$1776.001356878052 - PAVILION SURGERY CENTER LLC814376492 - (CA) PAVILION SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$1056.001245450295 - MDSINE, LLC, SPINE INSTITUTE OF NEW ENGLAND208141112 - (MA) MDSINE LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
46751$1600.001043760184 - AUBURN SURGERY CENTER INC431937843 - (MO) AUBURN SURGERY CENTER INCMOAmbulatory 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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