CPT 46930 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $215.10 Physician Fee Schedule |
National average reimbursement for CPT 46930 by major payers:
$238.55
$279.87
$292.30
$368.13
| 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 46930 | ||||||
United | 46930 | $609.00 | 1467490433 - UROLOGY SURGICAL CENTER LLC | 470814279 - (NE) UROLOGY SURGICAL CENTER | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $2292.00 | 1174969372 - AURORA GI ASC LLC, WISCONSIN DIGESTIVE HEALTH CENTER | 461848055 - (WI) AURORA GI ASC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $169.66 | 1306395439 - VIRGINIA LATOUCHE | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 46930 | $1843.00 | 1164056974 - ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC | 842016212 - (WI) ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $354.00 | 1437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC | 463556921 - (NC) PRIME SURGICAL SUITES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $1283.00 | 1447364682 - RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $180.00 | 1750568838 - VIVERE HEALTH DALLAS, LLC, VIVERE-DALLAS SURGERY CENTER | 364701304 - (TX) VIVERE HEALTH DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $424.00 | 1174502272 - ENDOSCOPY CENTER OF TOPEKA LP, THE ENDOSCOPY AND SURGERY CENTER OF TOPEKA | 621512368 - (KS) THE ENDOSCOPY CENTER OF TOPEKA L | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $210.00 | 1457320962 - FOOT AND ANKLE CENTER AT THE BURKLAND MEDICAL CENTER INC. | 522160415 - (MD) FOOT AND ANKLE CENTER AT THE BURKLAND MEDICAL CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $357.00 | 1518450790 - VIRGINIA ENT SURGERY CENTER INC | 541052755 - (VA) VIRGINIA EAR, NOSE & THROAT ASSOCIATES, P.C. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $369.27 | 1043451727 - BHARGAV TRIVEDI | 350593390 - DEACONESS HOSPITAL INC | IN | Neurology Physician (2084N0400X) |
United | 46930 | $169.66 | 1801178496 - KENDRA PARUS | 350593390 - DEACONESS HOSPITAL INC | IN | Acute Care Nurse Practitioner (363LA2100X) |
United | 46930 | $375.00 | 1528080876 - FRY EYE SURGERY CENTER, LLC | 742823718 - (KS) FRY EYE SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $459.00 | 1578918124 - CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | 811657416 - (ND) CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46930 | $1167.00 | 1922165901 - CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY, THE ROBERT ZUBOWSKI CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY | 200768828 - (NJ) CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY | 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 46930 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46930 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 46930 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 |
| 46922-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Surgical Excision |
| 46930-CPT | Moderate | Destruction Of Internal Hemorrhoids By Thermal Energy Eg Infrared Coagulation Cautery Radiofrequency |
| 46940-CPT | Moderate | Curet/Caut-Anal Fissure,Dilat;Init |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46930. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46930 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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