CPT 45114 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 23 - Emergency Room |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 22 - Increased Procedural Services • 80 - Assistant surgeon |
| Complexity Level | High |
| CMS | $1,769.03 Physician Fee Schedule |
National average reimbursement for CPT 45114 by major payers:
$2,175.19
$2,409.67
$2,487.27
$2,937.25
| 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 45114 | ||||||
United | 45114 | $523.00 | 1912480070 - SOG SURGERY CENTER LLC | 822479805 - (MS) SOG SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $424.00 | 1972850808 - LAKE RIDGE AMBULATORY SURGERY CENTER, LLC, LAKE RIDGE SURGERY CENTER | 455347932 - (VA) LAKE RIDGE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $316.00 | 1649325713 - LIBERTY EYE SURGICAL CENTER, LIBERTY SURGICAL CENTER | 200054137 - (PA) LIBERTY EYE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $316.00 | 1578600979 - HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER, METRO AMBULATORY SURGICAL CENTER | 522048920 - (MD) HOTCHKISS AND KATZEN AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $430.00 | 1215400320 - SURGERY CENTER AT GATEWAY LLC | 823763830 - (MI) SURGERY CENTER AT GATEWAY LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $107.00 | 1992794580 - VALLEY MEDICAL PLAZA AMBULATORY | 731718858 - (CA) VALLEY MEDICAL PLAZA AMBULATORY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $691.00 | 1629008677 - OPEN ACCESS VASCULAR ACCESS CENTER, INC | 650973601 - (FL) OPEN ACCESS VASCULAR ACCESS CE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $2172.00 | 1396742029 - GARLAND SURGICARE PARTNERS, LTD., BAYLOR SURGICARE AT GARLAND | 752764855 - (TX) GARLAND SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $1231.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $700.00 | 1871550392 - CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP | 61592173 - (CT) CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $825.00 | 1992759930 - IDAHO SURGICENTER INC, IDAHO SURGICENTER SOUTH | 200049792 - (ID) IDAHO SURGICENTER INC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $2668.00 | 1093245458 - GREAT LAKES SURGICAL SUITES, LLC, GREAT LAKES SURGICAL SUITES | 821350843 - (IN) GREAT LAKES SURGICAL SUITES, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $150.00 | 1689670390 - WILLIAMS EYE INSTITUTE, PC, WILLIAMS EYE SURGERY CENTER | 351401963 - (IN) WILLIAMS EYE INSTITUTE | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $1028.00 | 1285815522 - TLC ASC, LLC, KZMSS AGAIN, LLLP | 201952603 - (FL) TLC ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45114 | $969.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | 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 45114 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45114 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 45114 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 | Proctectomy W Part Resect Rectum |
| 45112-CPT | High | Proctectmy,Comb.Pull-Thru Proc,1-2 |
| 45113-CPT | High | Proctectomy, Partial, With Rectal Mucosectomy, Ileoanal Anastomosis, Creation Of Ileal Reservoir (S Or J), With Or Without Loop Ileostomy |
| 45114-CPT | High | Proctectomy W Anastomos Abd+Transac |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45114. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45114 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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