CPT 46910 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 • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $257.48 Physician Fee Schedule |
National average reimbursement for CPT 46910 by major payers:
$296.33
$325.62
$366.59
$426.80
| 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 46910 | ||||||
United | 46910 | $1700.00 | 1659420727 - THE ENDOSCOPY CENTER, INC. | 460450119 - (SD) THE ENDOSCOPY CENTER INC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $675.00 | 1689624793 - SURGERY CENTER OF SOUTHWEST FLORIDA INC | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $700.00 | 1376884585 - ADVANCED UROLOGY SURGERY CENTER | 461456287 - (GA) ADVANCED UROLOGY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $2933.18 | 1508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $1179.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $390.00 | 1861596967 - G.I.ENDOSCOPY CENTER | 581862189 - (GA) GIENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $420.00 | 1902876212 - SCAC LLC, SURGERY CENTER AT CRANBERRY | 562286973 - (PA) SCAC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $1233.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $538.00 | 1013048461 - GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP, A PROFESSIONAL, GASTROENTEROLOGY DIAGNOSTIC CENTER | 953921090 - (CA) GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP A PROFESSIONAL | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $721.00 | 1205908456 - ENDOSCOPY CENTER -PINEVILLE LLC, CAROLINA ENDOSCOPY CENTER -PINEVILLE | 260317153 - (NC) ENDOSCOPY CENTER PINEVILLE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $574.00 | 1487765897 - BAY MICROSURGICAL UNIT | 570799855 - (SC) BAY MICROSURGICAL UNIT | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $5127.00 | 1861913220 - SJV MANAGEMENT, LLC, SOUTH JERSEY VASCULAR SURGERY CENTER | 202273476 - (NJ) SJV MANAGEMENT, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $645.00 | 1669909404 - LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA, LUBBOCK VASCULAR ACCESS | 352344583 - (TX) LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $1990.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46910 | $2880.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | 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 46910 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46910 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 46910 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 |
|---|---|---|
| 46900-CPT | Moderate | Destruction Lesion(S), Anus, Simple; Che |
| 46910-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Electrodesiccation |
| 46916-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Cr |
| 46922-CPT | Moderate | 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 46910. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46910 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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