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See a sample rate comparisonCPT 46916 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 46916 |
| Medicaid Fee Schedule | View Medicaid rates for 46916 |
National average reimbursement for CPT 46916 by major payers:
$292.29
$309.42
$332.17
$248.92
Compare published rates across providers.
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CPT 46916
5 of 25 sample ratesHigher to lower in this preview
Endoscopy Center Of Ocean County, LLC
Endoscopy Center Of Ocean County, PC
$1,306.00Published rateChattanooga Pain Management Center LLC, Chattanooga Pain Surgery Center
Chattanooga Pain Management
$531.00Published rateSurgcenter Of Southern Maryland, LLC
Surgcenter Of Southern Maryland
$207.00Published rateUpstate Surgery Center, LLC
Upstate Surgery Center LLC
$101.00Published rateDigestive Health Specialists, PA
Digestive Health Specialists, P.A.
$35.00Published rate
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See a sample payer proposalCPT 46916 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46916 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 46916 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 |
|---|---|---|
| 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. |
| 46916-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. |
| 46917-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. |
| 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 46916. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46916 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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