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See a sample rate comparisonCPT 45111 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.
Partial Removal Of The Rectum, Surgical Removal Of A Portion Of The Rectum. The Remaining Healthy Segments Of The Rectum Are Reconnected.
| 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 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45111 |
| Medicaid Fee Schedule | View Medicaid rates for 45111 |
National average reimbursement for CPT 45111 by major payers:
$1,337.42
$1,446.86
$1,543.76
$1,744.35
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CPT 45111
5 of 25 sample ratesHigher to lower in this preview
Munster Specialty Surgery Center, LLC, Munster Specialty Surgery Center
Munster Specialty Surgery Center, LLC
$2,668.00Published rateCenter For Endoscopy LLC
$1,274.00Published rateHarmony Surgery Center, LLC, Harmony Ambulatory Surgery Center, LLC
Harmony Surgery Center LLC
$797.00Published rateChevy Chase Asc LLC, Chevy Chase Endoscopy Center
$429.00Published rateCarroll County Ambulatory Surgical Center
$245.00Published rate
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See a sample payer proposalCPT 45111 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45111 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 45111 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 |
|---|---|---|
| 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) |
| 45113-CPT | High | Proctectomy Partial With Rec, Proctectomy Partial With Rectal Mucosectomy Ileoanalanastomosis Creation Of Ileal Reservoir (S Or J) With Or Without Loop Ileostomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45111. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45111 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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