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See a sample rate comparisonCPT 46999 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Unlisted Procedure, Anus
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 51 - Multiple procedures UB |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 46999 |
| Medicaid Fee Schedule | View Medicaid rates for 46999 |
National average reimbursement for CPT 46999 by major payers:
$1,267.62
$92.71
$1,417.73
$815.08
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CPT 46999
5 of 25 sample ratesHigher to lower in this preview
Johnson County Surgery Center, L.P.
Johnson County Surgery Center Lp
$1,981.00Published rateNorth Haven Surgery Center LLC, North Haven Pain Medicine Center, LLC
North Haven Surgery Center LLC
$967.00Published rateBon Secours Surgery Center At Harbour View, LLC, Bon Secours Surgery Center At Harbour View
Bon Secours Surgery Center At Harbour View LLC
$636.00Published rateInsight Surgery Center, LLC
Insight Surgery Center LLC
$415.00Published rateZion Ambulatory Center LLC
$220.00Published rate
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See a sample payer proposalCPT 46999 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 46999 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 46999 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 |
|---|---|---|
| 46746-CPT | High | Repair Of Cloacal Anomaly, Repair Of Defect For Single Channel Outlet Of Rectum Vagina And Urinary Tract Via Incision Of Region Between Thighs Or Below Sacrum (Combined Abdominal And Sacroperineal Approach) |
| 46750-CPT | Moderate | Sphincteropl,Anal-Prolapse;Adult |
| 46945-CPT | Moderate | Int Hrhc Lig 1 Hroid W O Img, Hemorrhoidectomy Internal By Ligation Other Than Rubber Band Single Hemorrhoid Column Group Without Imaging Guidance |
| 46999-CPT | High | Unlisted Procedure, Anus |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 46999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 46999 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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