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See a sample rate comparisonCPT 45113 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.
Proctectomy Partial With Rec, Proctectomy Partial With Rectal Mucosectomy Ileoanalanastomosis Creation Of Ileal Reservoir (S Or J) With Or Without Loop Ileostomy
| 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 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45113 |
| Medicaid Fee Schedule | View Medicaid rates for 45113 |
National average reimbursement for CPT 45113 by major payers:
$2,436.04
$2,533.48
$2,649.20
$3,036.13
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CPT 45113
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Atlantis LLC
$2,732.00Published rateNewport Beach Surgery Center, LLC, Newport Beach Surgery Center
Newport Beach Surgery Center LLC
$921.00Published rateMenlo Park Surgery Center, LLC.
Menlo Park Surgery Center LLC
$675.00Published rateThe Hutchinson Ophthalmology Asc LLC, Surgery Center Of South Central Kansas
The Hutchinson Ophthalmology Asc LLC
$463.00Published rateAkdhc Surgery Center, LLC
$100.00Published rate
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See a sample payer proposalCPT 45113 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45113 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 45113 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 |
|---|---|---|
| 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 |
| 45114-CPT | High | Proctectomy Partial W/ Anastomsis; Abdomi & Transsacral Appr, Proctectomy Partial With Anastomosis; Abdominal And Transsacral Appr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45113. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45113 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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