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See a sample rate comparisonCPT 46761 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Sphincteroplast Anal For Ncontinenc Adult; Lvator Muscl Imbric, Sphincteroplasty Anal For Incontinence Adult; Levator Muscle Imbric
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46761 |
| Medicaid Fee Schedule | View Medicaid rates for 46761 |
National average reimbursement for CPT 46761 by major payers:
$1,115.56
$1,220.32
$1,246.68
$1,473.88
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CPT 46761
5 of 25 sample ratesHigher to lower in this preview
Greenville Surgery Center, LLC, Texas Health Surgery Center Dallas
Greenville Surgery Center LLC
$6,342.00Published ratePhysicians Ambulatory Surgery Center, LLC
$3,794.00Published rateSurgery Center Of Mount Dora, LLC
Surgery Center Of Mount Dora
$2,655.00Published rateTulsa Ok Endoscopy Asc LLC, Tulsa Endoscopy Center
Tulsa Endoscopy Center, LLC
$1,456.34Published rateLaser Surgery Holding Company, Ltd
Laser Surgery Holding Company Lt
$561.00Published rate
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See a sample payer proposalCPT 46761 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46761 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 46761 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 |
|---|---|---|
| 46760-CPT | High | Sphincteroplasty Anal For Ncontinenc Adult; Muscl Transplnt, Sphincteroplasty Anal For Incontinence Adult; Muscle Transplant |
| 46761-CPT | High | Sphincteroplast Anal For Ncontinenc Adult; Lvator Muscl Imbric, Sphincteroplasty Anal For Incontinence Adult; Levator Muscle Imbric |
| 46910-CPT | Moderate | Anus Surgery To Remove Growth, Surgery To Destroy And Remove Abnormal Tissue From The Anus. The Tissue May Be Destroyed With Heat Cold Chemicals Or A Laser. |
| 46922-CPT | Moderate | Excision Of Anal Lesion S, Destruction Of Lesion S Anus Eg Condyloma Papilloma Molluscum Contagiosum Herpetic Vesicle Simple Surgical Excision |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46761. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46761 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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