CPT 46753 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $610.70 Physician Fee Schedule |
National average reimbursement for CPT 46753 by major payers:
$758.40
$796.39
$841.06
$995.83
| 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 46753 | ||||||
United | 46753 | $2038.00 | 1790066876 - CAROMONT HEALTH SERVICES, INC., CAROMONT ENDOSCOPY CENTER | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $1200.00 | 1922531268 - AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | 814584087 - (MD) AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $2311.00 | 1447269790 - WEST BEND SURGERY CENTER LLC | 391954169 - (WI) WEST BEND SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $2500.00 | 1780789024 - LINDEN SURGICAL CENTER, LLC | 223634504 - (NJ) LINDEN SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $3599.00 | 1497749667 - CALIFORNIA SPECIALTY SURGERY CENTER, LLC, CALIFORNIA SPECIALTY SURGERY CENTER, LLC | 330939003 - (CA) CALIFORNIA SPECIALTY SURGERY CENTER, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $2762.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $951.00 | 1790167740 - TIDALHEALTH SURGERY CENTER, LLC | 474184623 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $1023.00 | 1134427297 - SURGERY CENTER OF ZACHARY, LLC | 811928790 - (LA) SURGERY CENTER OF ZACHARY, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $1514.00 | 1780851691 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $1645.00 | 1285282343 - DEERBROOK SURGERY CENTER LLC, KINGWOOD ENDOSCOPY | 813375333 - (TX) DEERBROOK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $569.00 | 1205929080 - OAK TREE SURGERY CENTER, LLC | 223524889 - (NJ) OAK TREE SURGERY CENTER, LL, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $1025.00 | 1902876212 - SCAC LLC, SURGERY CENTER AT CRANBERRY | 562286973 - (PA) SCAC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $2280.00 | 1790320612 - GS CAMPUS ASC, LLC, LAFAYETTE SURGERY CENTER | 821536566 - (CO) GS CAMPUS ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $2080.00 | 1821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER | 205953364 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46753 | $2859.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | 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 46753 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46753 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 46753 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 |
| 46753-CPT | Moderate | Graft-Rectal Incontinence/Prolpse |
| 46754-CPT | Moderate | Remove Thiersch Wire/Suture |
| 46945-CPT | Moderate | Hemorrhoidectomy Internal By Ligation Other Than Rubber Band; Single Hemorrhoid Column/Group 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 46753. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46753 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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