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See a sample rate comparisonCPT 39545 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.
Repair Of Diaphragm Hernia, Surgery To Repair An Opening In The Diaphragm That Has Allowed Abdominal Organs To Protrude Into The Upper Chest. The Organs Are Pushed Back Into Place And The Stretched Diaphragm Stitched Back To Its Proper Size.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Mediastinum and Diaphragm |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | $872.77 national non-facility rate (2026) · View Medicare rates for 39545 |
| Medicaid Fee Schedule | $684.89 median of the 8 states in the free preview · View Medicaid rates for 39545 |
National average reimbursement for CPT 39545 by major payers:
$1,091.45
$1,180.96
$1,222.53
$1,440.93
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CPT 39545
5 of 25 sample ratesHigher to lower in this preview
The Hand Center, LLC
$13,332.00Published rateEast West Surgery Center Lp
$1,064.00Published rateAdventhealth Surgery Center Mills Park LLC, Adventhealth Surgery Center Mills Park
Adventhealth Surgery Center Mills Park LLC
$1,049.00Published rateBaptist Germantown Surgery Center, LLC, Baptist Germantown Surgery Center
Baptist Germantown Surgery Center LLC
$640.00Published rateSurgery Center Of St. Joseph, LLC
Surgery Center Of St Joseph LLC
$66.00Published rate
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See a sample payer proposalCPT 39545 vs. Other Surgical Procedures on the Mediastinum and Diaphragm Codes
The CPT 39545 code is part of the Surgery services used for Surgical Procedures on the Mediastinum and Diaphragm. 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 39545 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 |
|---|---|---|
| 39503-CPT | High | Repair Of A Stomach Hernia, Surgery To Repair A Stomach Hernia. The Protruding Stomach Is Moved Back Into Place And The Opening In The Diaphragm Is Stitched Smaller. Mesh May Be Implanted To Hold The Tissue In Place. |
| 39540-CPT | High | Repair Of Diaphragm Injury, Surgery To Repair A Serious Injury To The Diaphragm That Pushes The Abdominal Contents Up Into The Chest Cavity. The Diaphragm Hole Is Patched Or Stitched Closed. |
| 39541-CPT | High | Repair Of Diaphragm Injury, Surgery To Repair A Serious Injury To The Diaphragm That Pushes The Abdominal Contents Up Into The Chest Cavity. The Diaphragm Hole Is Patched Or Stitched Closed. |
| 39545-CPT | High | Repair Of Diaphragm Hernia, Surgery To Repair An Opening In The Diaphragm That Has Allowed Abdominal Organs To Protrude Into The Upper Chest. The Organs Are Pushed Back Into Place And The Stretched Diaphragm Stitched Back To Its Proper Size. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 39545. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 39545 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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