CPT 46945 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XS - Separate Structure |
| Complexity Level | Moderate |
| CMS | $336.40 Physician Fee Schedule |
National average reimbursement for CPT 46945 by major payers:
$391.18
$407.30
$449.23
$533.67
| 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 46945 | ||||||
United | 46945 | $1440.00 | 1962400044 - COA ASC OF FRANKLIN COUNTY LLC, COLUMBUS EYE SURGERY CENTER | 311454133 - (OH) COA ASC OF FRANKLIN COUNTY LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1858.00 | 1861059818 - FISHERS SPECIALTY SURGERY CENTER, LLC, ORTHOALLIANCE OF INDIANA | 833241405 - (IN) FISHERS SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1107.00 | 1023399318 - CANDESCENT EYE SURGICENTER LLC | 452898656 | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1894.00 | 1568423945 - NW AMBULATORY SURGERY CENTER LLP, NW SURGERY CENTER | 383693604 - (TX) NW AMBULATORY SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $787.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 812203868 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $2206.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $630.00 | 1730249327 - AMBULATORY SURGERY CENTER OF WNY | 161554732 - (NY) AMBULATORY SURGERY CENTER OF WNY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1061.00 | 1245580711 - AMSTERDAM REC LLC, MOHAWK VALLEY EYE SURGERY CENTER | 453808566 - (NY) AMSTERDAM REC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1550.00 | 1558327338 - DANBURY SURGICAL CENTER LP, SURGICAL CENTER OF RIDGEFIELD | 631263704 - (CT) DANBURY SURGICAL CENTER LP | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1002.00 | 1316290380 - ATHENS SURGERY CENTER LLC, THE SURGERY CENTER OF ATHENS | 800812776 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1819.00 | 1497752745 - ORTHOPEDIC SOUTH SURGICAL PARTNERS, LLC, ORTHOPAEDIC SOUTH SURGICAL CENTER | 260008898 - (GA) ORTHOPEDIC SOUTH SURGICAL PARTNERS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $3877.00 | 1528339447 - CP SURGERY CENTER, LLC | 800776412 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $2516.00 | 1679985857 - FOUNTAIN VALLEY SURGERY CENTER, LLC | 371756991 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1203.00 | 1528130879 - PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 330776873 - (CA) PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $928.00 | 1245868488 - AVON SURGERY CENTER, LLC | 823987550 - (OH) AVON SURGERY CENTER LLC | OH | 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 46945 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46945 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 46945 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 |
|---|---|---|
| 46753-CPT | Moderate | Graft-Rectal Incontinence/Prolpse |
| 46916-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Cr |
| 46924-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Extensive (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery) |
| 46945-CPT | Moderate | Hemorrhoidectomy Internal By Ligation Other Than Rubber Band; Single Hemorrhoid Column/Group Without Imaging Guidance (Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46945. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46945 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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