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 |
| Medicare Fee Schedule | View Medicare rates for 46922 |
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 | $1224.00 | 1376556514 - EYE CARE SPECIALISTS PS, THE LASER AND SURGERY CENTER | 911895676 - (WA) EYECARE SPECIALIST, PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $2206.00 | 1588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC | 201243484 - (AL) ALABAMA DIGESTIVE HEALTH | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $4263.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | 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 | $922.00 | 1356421853 - PINEHURST MEDICAL CLINIC INC, PINEHURST MEDICAL CLINIC ENDOSCOPY CENTER | 560942980 - (NC) PINEHURST MEDICAL CLINIC, INC. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $2353.00 | 1902302961 - HILL COUNTRY SURGERY CENTER, LLC, SURGERY CENTER OF BOERNE | 352599588 - (TX) HILL COUNTRY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1400.00 | 1669427043 - VANCOUVER EYE CARE PS | 910913651 - (WA) VANCOUVER EYE CARE, P.S. | WA | 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 | $1550.00 | 1417304171 - COLLIN COUNTY ASC, LP, MEDFINITY HEALTH SURGERY CENTER - PLANO | 475615966 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1144.00 | 1982783270 - DERMATOLOGY SURGERY CENTER, LLC, LASER & SKIN SURGERY CENTER | 593680567 - (SC) DERMATOLOGY SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $2388.00 | 1841626090 - COLUMBUS ENDOSCOPY CENTER LLC | 463368948 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $519.00 | 1649244567 - LAKELAND FL ENDOSCOPY ASC LLC, SURGERY CENTER OF LAKELAND HILLS BOULEVARD | 200288888 - (FL) LAKELAND FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $2500.00 | 1407317019 - RIVERSIDE SURGICAL CENTER OF MEADOWLANDS, LLC, RIVERSIDE SURGICAL CENTER OF RUTHERFORD | 832735771 - (NJ) RIVERSIDE SURGICAL CENTER OF MEADOWLANDS LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $1840.00 | 1912158684 - SURGCENTER OF BEL AIR | 262215322 - (MD) SURGCENTER OF BEL AIR, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46922 | $944.88 | 1750358453 - CENTER FOR DIGESTIVE HEALTH LTD | 391738062 - (WI) THE CENTER FOR DIGESTIVE HEALTH LTD | WI | 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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