CPT 46922 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $300.82 Physician Fee Schedule |
National average reimbursement for CPT 46922 by major payers:
$325.80
$358.41
$409.59
$485.10
| 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 46922 | ||||||
United | 46922 | $1323.00 | 1457898215 - PROSPECT BLACKSTONE VALLEY SURGICARE, LLC, BLACKSTONE VALLEY SURGICARE | 814871794 - (RI) PROSPECT BLACKSTONE VALLEY SURGICARE LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $580.00 | 1821101197 - OLYMPIA MULTI-SPECIALTY CLINIC AMBULATORY PROCEDURES CNTR PLLC | 911703278 - (WA) OLYMPIA MULTISPECIALTY CLINIC AMBULATORY PROCEDURES CNTR PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1318.00 | 1285944504 - NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK, LLC | 272840356 - (MD) NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1084.00 | 1811001548 - AMBULATORY SURGERY CENTER OF OPELOUSAS | 721502278 - (LA) AMBULATORY SURGERY CENTER OF O | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $580.00 | 1104947357 - TARRANT COUNTY SURGERY CENTER LP | 710985084 - (TX) TARRANT COUNTY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $687.00 | 1396193033 - NEW BERLIN MEDICAL SERVICES, LLC | 811190440 - (WI) NEW BERLIN MEDICAL SERVICES LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $903.00 | 1205221470 - NEWSOM SURGERY CENTER OF SEBRING LLC | 472439597 - (FL) NEWSOM SURGERY CENTER OF SEBRING LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1184.00 | 1417295528 - ATLANTA GENERAL AND BARIATRIC SURGERY CENTER, LLC | 460797514 - (GA) ATLANTA GENERAL AND BARIATRIC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $580.00 | 1417626144 - VALLEY BAPTIST SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1045.00 | 1629078043 - NOVAMED EYE SURGERY CENTER OF OVERLAND PARK, LLC, OVERLAND PARK SURGERY CENTER | 364130546 - (KS) NOVAMED EYE SURGERY CENTER OF OVERLAND PARK LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $870.00 | 1508863242 - BUFFALO SURGERY CENTER LLC | 161574540 - (NY) BUFFALO SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $970.00 | 1588237523 - CARDIO-KIDNEY VASCULAR CARE LLC | 851989732 - (KS) CARDIO-KIDNEY VASCULAR CARE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $3500.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $580.00 | 1164527933 - NORTHWEST AMBULATORY SURGERY SERVICES, LLC, BELLINGHAM AMBULATORY SURGERY CENTER | 911830115 - (WA) NORTHWEST AMBULATORY SURGERY SERVICES, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $826.00 | 1821064031 - PIEDMONT DAY SURGERY CENTER INC | 541514162 | VA | 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 46922 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46922 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 46922 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 |
| 46917-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Laser Surgery |
| 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 46922. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46922 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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