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See a sample rate comparisonCPT 46751 Fee Schedule
Last Verified: October 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 Fact | Detail |
|---|---|
| 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 Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46751 |
| Medicaid Fee Schedule | View Medicaid rates for 46751 |
National average reimbursement for CPT 46751 by major payers:
$810.82
$854.13
$896.79
$1,050.95
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CPT 46751
5 of 25 sample ratesHigher to lower in this preview
Aurora Gi Asc LLC, Wisconsin Digestive Health Center
Aurora Gi Asc LLC
$16,236.00Published rateAuburn Surgery Center Inc
$1,600.00Published rateTimpview Asc, LLC
Timpview Asc LLC
$860.00Published rateChristus Santa Rosa Pasc-San Antonio LLC, Christus Surgery Center - Alamo Heights
Christus Srpasc - San Antonio, LLC
$501.00Published rateNorwood Endoscopy Center, LLC
$125.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 46750-CPT | Moderate | Sphincteropl,Anal-Prolapse;Adult |
| 46751-CPT | Moderate | Sphincteroplasty Anal Child |
| 46900-CPT | Moderate | Destruction Of Lesion(S) Anu, Destruction Of Lesion(S) Anus (Eg Condyloma Papillomamolluscum Contagiosum Herpetic Vesicle) Simple Chemical Destruction Of Lesion(S) Anus (Eg Condyloma Papilloma |
| 46924-CPT | Moderate | Destruction Anal Lesion S, Destruction Of Lesion S Anus Eg Condyloma Papilloma Molluscum Contagiosum Herpetic Vesicle Extensive Eg Laser Surgery Electrosurgery Cryosurgery Chemosurgery |
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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