CPT 46946 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 • SG - Scene to Hospital ESRD facility |
| Complexity Level | Moderate |
| CMS | $374.25 Physician Fee Schedule |
National average reimbursement for CPT 46946 by major payers:
$439.46
$448.97
$493.07
$587.56
| 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 46946 | ||||||
United | 46946 | $693.00 | 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 | 46946 | $746.00 | 1164601696 - SALVATORE DIMERCURIO MD PA | 521833726 - (MD) SALVATORE DIMERCURIO, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $987.00 | 1063495257 - DOCTORS SURGICAL PARTNERSHIP LLC, MELBOURNE SAME DAY SURGERY | 593490279 - (FL) DOCTORS SURGICAL PARTNERSHIP LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $886.00 | 1154986347 - CENTER FOR VISUAL SURGICAL EXCELLENCE, LLC | 820674025 - (VA) CENTER FOR VISUAL SURGICAL EXCELLENCE LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $526.00 | 1720833163 - MIDWEST EYE CENTER | 363010536 - (IL) MIDWEST EYE CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $2307.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $875.00 | 1033760723 - ADVANCED SURGERY CENTER OF OXFORD | 825522826 - (FL) OXFORD SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $774.00 | 1043239338 - NORTH VALLEY ENDOSCOPY CENTER LLC | 201729172 - (AZ) NORTH VALLEY ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $2353.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $2200.00 | 1720033293 - CLINIC SURGERY CENTER, LLC, NEW TAMPA SURGERY CENTER | 883196649 - (FL) CLINIC SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $1282.00 | 1043680440 - SOUTHWEST MEDICAL ASSOCIATES, INC, SOUTHWEST MEDICAL ASSOCIATES - TENAYA | 880201420 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $2353.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $3000.00 | 1730603622 - DULUTH SURGICAL SUITES LLC | 820668583 - (MN) DULUTH SURGICAL SUITES LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $6874.00 | 1699445981 - ELKO COMMUNITY HEALTH CENTER, LLC | 851569152 - (NV) ELKO COMMUNITY HEALTH CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46946 | $2178.00 | 1053362343 - SODERSTROM DERMATOLOGY CENTER S C, PEORIA AMBULATORY SURGERY CENTER | 371001642 - (IL) SODERSTROM DERMATOLOGY CENTER, S.C. | IL | 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 46946 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46946 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 46946 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 |
|---|---|---|
| 46916-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Cr |
| 46922-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Surgical Excision |
| 46924-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Extensive (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery) |
| 46946-CPT | Moderate | Hemorrhoidectomy Internal By Ligation Other Than Rubber Band; 2 Or More Hemorrhoid Columns/Groups 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 46946. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46946 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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