CPT 46607 Medicare payment status

Global period: what 46607's fee already covers Copy link

The fee covers pre-operative and post-operative work on the day of the procedure only—there is no follow-up window afterward. A visit the next day is separately payable.

A modifier reports what happened; it does not by itself make a service payable. Documentation has to support it.

Billing policy Copy link

These billing-policy indicators explain how 46607 is treated. They apply whether the code is nationally priced or carrier-priced: a restriction like "bilateral not allowed" still matters on a carrier-priced code.

Check a pair of codes Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.

See every current NCCI pair for 46607 →

Why a 46607 line may not pay separately Copy link

CMS publishes no separately payable amount for 46607 in this release, so reconciling the line means establishing which status governed the date of service rather than chasing a fee-schedule difference.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

Rate history by release Copy link

National Office (non-facility) amount for 46607 across quarterly releases. +18.1% increase since Q1 2016 · peak $230.80 in Q1 2026

How often 46607 is billed Copy link

Across Original Medicare in CY2024, 46607 ranked #3,521 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2015 fee schedule above.