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See a sample rate comparisonCPT 46754 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.
Rectum Incontinence Surgery, Surgery To Remove Wires Or Sutures From The Anal Canal Following Surgical Treatment For Rectal Prolapse (Condition Where Wall Of Rectum Falls Out Of Place And Protrudes From Anus).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility 49 - Independent Clinic |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46754 |
| Medicaid Fee Schedule | View Medicaid rates for 46754 |
National average reimbursement for CPT 46754 by major payers:
$377.28
$402.22
$445.12
$525.45
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CPT 46754
5 of 25 sample ratesHigher to lower in this preview
Baylor Surgicare At Mansfield, LLC, Baylor Scott & White Surgicare - Mansfield
$2,172.00Published rateAdvanced Surgery Center Of Central Iowa, LLC
Advanced Surgery Center Of Central Iowa LLC
$1,101.00Published rateMaplewood Ambulatory Surgery Center, Inc.
Maplewood Ambulatory Surgery Center Inc
$817.00Published rateChevy Chase Asc LLC, Chevy Chase Endoscopy Center
$533.00Published rateTracy Deno-Buechlein
Deaconess Hospital Inc
$254.57Published rate
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See a sample payer proposalCPT 46754 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46754 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 46754 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 | Rectum Incontinence Surgery, Surgical Treatment For Rectal Prolapse (Condition Where Wall Of Rectum Falls Out Of Place And Protrudes From Anus) Or Incontinence (Inability To Hold Feces). |
| 46754-CPT | Moderate | Rectum Incontinence Surgery, Surgery To Remove Wires Or Sutures From The Anal Canal Following Surgical Treatment For Rectal Prolapse (Condition Where Wall Of Rectum Falls Out Of Place And Protrudes From Anus). |
| 46945-CPT | Moderate | Int Hrhc Lig 1 Hroid W O Img, Hemorrhoidectomy Internal By Ligation Other Than Rubber Band Single Hemorrhoid Column Group Without Imaging Guidance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46754. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46754 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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