CPT 48146 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 22 - Increased Procedural Services • GC - Service performed by resident under supervision |
| Complexity Level | High |
| CMS | $1,833.72 Physician Fee Schedule |
National average reimbursement for CPT 48146 by major payers:
$2,337.91
$2,490.60
$2,623.00
$3,047.74
| 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 48146 | ||||||
United | 48146 | $420.00 | 1730514027 - KY ADVANCED SURGICAL CENTER INC | 901005366 - (CA) KY ADVANCED SURGICAL CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $3078.00 | 1447916259 - BJOSC, LLC, BJOSC, LLC @ WESTWOOD | 300391378 - BJOSC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $625.00 | 1093389421 - PEACHTREE ORTHOPAEDIC SURGERY CENTER-NORTH, LLC | 862640910 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTERNORTH LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $389.00 | 1508846411 - FIRST STATE SURGERY CENTER, LLC | 510402966 - (DE) FIRST STATE SURGERY CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $2172.00 | 1982607446 - DENTON SURGICARE PARTNERS, LTD., DENTON SURGICARE | 752708579 - (TX) DENTON SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $900.00 | 1134363690 - OAM SURGERY CENTER AT MIDTOWNE, LLC, METRO HEALTH OAM SURGERY CENTER | 261805066 - (MI) OAM SURGERY CENTER AT MIDTOWNE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $369.00 | 1710931134 - NOVAMED SURGERY CENTER OF JONESBORO, LLC, EYE SURGERY CENTER OF ARKANSAS | 204407053 - (AR) NOVAMED SURGERY CENTER OF JONESBORO LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $317.00 | 1275574154 - DOCTORS SURGERY CENTER OF TEXARKANA, DOCTOR'S SURGERY CENTER | 710796220 - (AR) DOCTORS SURGERY CENTER OF TEXARKANA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $925.15 | 1396990701 - PEACEHEALTH, ST JOSEPH MEDICAL CENTER | 910565889 - PEACEHEALTH ST JOSEPH MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $640.00 | 1386721249 - ALLIED PHYSICIANS SURGERY CENTER, LLC | 352057452 - (IN) ALLIED PHYSICIANS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $1306.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $1049.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $416.00 | 1669031886 - SURGICAL CLINIC SOLUTIONS, LLC | 823722886 - (AL) SURGICAL CLINIC SOLUTIONS | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $375.00 | 1265657258 - EYE SURGERY CENTER OF NORTH ALABAMA, INC. | 450506013 - (AL) EYE SURGERY CENTER OF NORTH ALABAMA, INC. | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48146 | $690.00 | 1164976478 - FRANCISCAN MEDICAL GROUP, THE DOCTORS CLINIC AMBULATORY SURGICAL CENTER, A PART OF THE FRANCISCA | 911939739 - FRANCISCAN MEDICAL GROUP | 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 |
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CPT 48146 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48146 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 48146 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 |
|---|---|---|
| 48140-CPT | High | Pancreatectomy Distal Subtotal |
| 48145-CPT | High | Pancreatectomy Distal W Jejunostomy |
| 48146-CPT | High | Pancreatectomy,Distal,Near-Totl,W Duodenum Preservatn(Child-Type Proc) |
| 48150-CPT | High | Pancreatectomy, Proximal Subtotal With Total Duodenectomy, Partial Gastrectomy, Choledochoenterostomy And Gastrojejunostomy (Whipple-Type Procedure); With Pancreatojejunostomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48146. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48146 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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