CPT 45000 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 |
| Common Modifiers | • None • 51 - Multiple procedures • 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45000 |
National average reimbursement for CPT 45000 by major payers:
$526.11
$552.40
$593.08
$695.77
| 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 45000 | ||||||
United | 45000 | $2114.00 | 1669787958 - PINE RIDGE SURGERY CENTER, LLC | 271609169 - (WI) PINE RIDGE SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $575.00 | 1427307578 - HEMLOCK AMBULATORY SURGERY CENTER | 455511791 - (GA) HEMLOCK AMBULATORY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $898.00 | 1144275900 - MT LAUREL ENDOSCOPY CENTER L P | 562350370 - (NJ) MT LAUREL ENDOSCOPY CENTER L P | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $515.00 | 1952602609 - GASTROENTEROLOGY & HEPATOLOGY CONSULTANTS, PA, WAKE FOREST ENDOSCOPY CENTER | 562189630 - (NC) GASTROENTEROLOGY AND HEPATOLOGY CONSULTANTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $629.00 | 1013298926 - MATTHEWS SURGERY CENTER, LLC | 273634811 - (NC) MATTHEWS SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $557.00 | 1578531208 - NORTHEAST ENDOSCOPY CENTER, LLC | 841665375 - (GA) NORTHEAST ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $1231.00 | 1063453561 - TEMPLETON SURGERY CENTER, LLC, TEMPLETON SURGERY CENTER | 202246616 - (CA) TEMPLETON SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $794.00 | 1194437624 - WATAUGA SURGICAL PARTNERS PLLC | 862624496 - (TN) WATAUGA SURGICAL PARTNERS PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $650.00 | 1750609731 - BELTLINE SURGERY CENTER, LLC | 262639054 - (TX) BELTLINE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $950.00 | 1043835713 - IDAHO ENDOSCOPY CENTER LLC, NAMPA IDAHO ENDOSCOPY CENTER | 270996353 - (ID) IDAHO ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $475.00 | 1639386659 - MIDWEST EYE CONSULTANTS, P.C., CLI SURGERY CENTER | 351845786 - (IN) MIDWEST EYE CONSULTANTS, P.C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $502.00 | 1265770572 - PHILADELPHIA SURGERY CENTER, INC. | 454790325 - (PA) PHILADELPHIA SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $813.00 | 1669437497 - CASCADE SURGICENTER, LLC | 731677879 - (OR) CASCADE SURGICENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $2363.00 | 1508835299 - ALASKA DIGESTIVE CENTER, LLC | 481281732 - (AK) ALASKA DIGESTIVE CENTER LLC | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45000 | $576.00 | 1538117841 - SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC, SHELBY AMBULATORY SURGERY AT THE PHYSICIANS CENTER | 203150946 - (AL) SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC | AL | 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 45000 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45000 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 45000 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45000 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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