Rate Benchmarking
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See a sample rate comparisonHealthcare 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 |
| Common Modifiers | None 22 - Increased Procedural Services GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45110 |
| Medicaid Fee Schedule | View Medicaid rates for 45110 |
National average reimbursement for CPT 45110 by major payers:

$2,174.97

$2,443.39

$2,599.62

$2,927.00
Choose a payer to see a sample of rates for CPT 45110.
Aurora Surgery Centers LLC
Fullerton Surgical Center Lp
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 45110 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45110 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 45110 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 |
|---|---|---|
| 45108-CPT | Moderate | Myomectomy Anorectal |
| 45110-CPT | High | Remove The Rectum, Surgical Removal Of The Rectum And The Anus. Waste Is Expelled Through A Surgically Created Opening In The Abdominal Wall (Stoma). |
| 45111-CPT | High | Partial Removal Of The Rectum, Surgical Removal Of A Portion Of The Rectum. The Remaining Healthy Segments Of The Rectum Are Reconnected. |
| 45112-CPT | High | Removal Of Rectum, Removal Of Rectum And Suturing Of Large Bowel To Anus Via Incision Of Abdomen And Region Between Thighs (Combined Abdominoperineal Approach) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45110 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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