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 |
| Medicare Fee Schedule | View Medicare rates for 46945 |
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 | $2040.00 | 1437427333 - TOWER CLOCK SURGERY CENTER LLC | 453636581 - (WI) TOWER CLOCK SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $4577.00 | 1619944824 - WAVERLEY SURGERY CENTER LLC, WAVERLEY SURGERY CENTER | 20554398 - (CA) WAVERLEY SURGERY CENTER, L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1040.00 | 1528009453 - TGLP, LP, THE ENDOSCOPY CENTER OF TEXARKANA | 201584968 - (TX) TGLP LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1300.00 | 1306435086 - PHOENIX SPINE AND JOINT GILBERT ASC, LLC | 853605981 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1200.00 | 1023542339 - BATON ROUGE VASCULAR ACCESS ASC LLC | 814685509 - (LA) BATON ROUGE VASCULAR ACCESS ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $900.00 | 1164662912 - SPACE COAST SURGERY CENTER LLC | 263184352 - (FL) SPACE COAST SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1523.00 | 1285213009 - UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE, LLC, UM SHORE REGIONAL HEALTH SURGERY CENTER AT CAMBRIDGE | 372002744 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $663.00 | 1710213400 - VISION SURGERY CENTER, LLC | 371579446 - (OH) VISION SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $715.00 | 1598965634 - LAKE CITY SURGERY CENTER, LLC | 260811545 - (FL) LAKE CITY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $2353.00 | 1477569069 - FISH POND SURGERY CENTER, LLC | 742901471 - (TX) FISH POND SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $553.52 | 1376587345 - DONNA LILLY | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Social Worker (1041C0700X) |
United | 46945 | $2307.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $1350.00 | 1740479476 - MEADOW LAKE SURGERY CENTER INC | 204804837 - (ID) MEADOW LAKE SURGERY CENTER INC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $575.00 | 1801869292 - AMSURG NORTHERN KENTUCKY GI LLC, ST. ELIZABETH PHYSICIANS ENDOSCOPY CENTER | 621719097 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46945 | $4453.00 | 1063442077 - INOVA LOUDOUN AMBULATORY SURGERY | 203523190 - (VA) INOVA LOUDOUN AMBULATORY SURGERY | 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 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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