CPT 46999 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 46999 by major payers:
$1,267.62
$92.71
$1,417.73
$818.28
| 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 46999 | ||||||
United | 46999 | $700.00 | 1013104389 - TRACY SURGERY CENTER, LLC, TRACY SURGERY CENTER, LLC | 203762687 - (CA) TRACY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $296.00 | 1003815242 - DOTHAN SURGERY CENTER, LLC, DOTHAN SURGERY CENTER | 631267139 - (AL) DOTHAN SURGERY CENTER, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $993.00 | 1588328918 - HARLEM ROAD AMBULATORY SURGERY CENTER LLC | 833648797 - (NY) HARLEM ROAD AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $953.00 | 1558794081 - SURGERY CENTER OF SCOTTSDALE, LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $280.00 | 1912476367 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $399.00 | 1023043445 - AESTHETIC EYE ASSOCIATES, PS, ALLURE LASER CENTER & MEDISPA | 911577091 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $636.00 | 1568505899 - BON SECOURS SURGERY CENTER AT HARBOUR VIEW, LLC, BON SECOURS SURGERY CENTER AT HARBOUR VIEW | 208302537 - (VA) BON SECOURS SURGERY CENTER AT HARBOUR VIEW LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $578.00 | 1013468586 - LAKEWAY AMBULATORY SURGERY CENTER, LLC, LAKEWAY SURGERY CENTER | 383992761 - (TX) LAKEWAY AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $594.00 | 1245806876 - WICHITA UROLOGY SURGERY CENTER,LLC | 834482229 - (KS) WICHITA UROLOGY SURGERY CENTERLLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $549.00 | 1295403426 - DRS LLC, MCMINNVILLE SURGERY CENTER | 320613056 - (OR) DRS LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $967.00 | 1447362769 - BETHLEHEM ENDOSCOPY CENTER LLC | 233032591 - (PA) BETHLEHEM ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $298.00 | 1063495257 - DOCTORS SURGICAL PARTNERSHIP LLC, MELBOURNE SAME DAY SURGERY | 593490279 - (FL) DOCTORS SURGICAL PARTNERSHIP LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $700.00 | 1396796249 - TAMPA BAY SURGERY CENTER ASSOCIATES, LTD. | 593210851 - (FL) TAMPA BAY SURGERY CENTER ASSOC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $1560.00 | 1548446669 - INNOVIS HEALTH, LLC, ESSENTIA HEALTH WAHPETON ASC | 261175213 - INNOVIS HEALTH LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 46999 | $470.00 | 1588765739 - NORTHWEST ENDOSCOPY CENTER, LLC | 911919202 - (WA) NORTHWEST ENDOSCOPY CENTER LLC | WA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 Defect For Single Channel Outlet Of Rectum, Vagina, And Urinary Tract Through Abdomen And Region Between Thighs Or Below Sacrum |
| 46750-CPT | Moderate | Sphincteropl,Anal-Prolapse;Adult |
| 46922-CPT | Moderate | Destruction Of Lesion(S), Anus (Eg, Condyloma, Papilloma, Molluscum Contagiosum, Herpetic Vesicle), Simple; Surgical Excision |
| 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 46999) and we'll show you how you compare in 15 minutes or less.