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See a sample rate comparisonCPT 45119 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.
Remove Rectum W Reservoir, Proctectomy Combined Abdominoperineal Pull Through Procedure Eg Colo Anal Anastomosis With Creation Of Colonic Reservoir Eg J Pouch With Diverting Enterostomy When Performed
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | None 22 - Increased Procedural Services 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45119 |
| Medicaid Fee Schedule | View Medicaid rates for 45119 |
National average reimbursement for CPT 45119 by major payers:
$2,360.66
$2,567.53
$2,620.41
$3,128.05
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CPT 45119
5 of 25 sample ratesHigher to lower in this preview
Walnut Hill Surgery Center, LLC
Walnut Hill Surgery Center LLC
$6,068.00Published rateTenn Sm LLC
$1,064.00Published rateWestern Washington Endoscopy Centers, LLC
Western Washington Endoscopy Centers LLC
$690.00Published rateSnowden River Surgery Center LLC
$416.00Published ratePhoenix Asc, Lp, Cardiac Surgery Center Of Phoenix
$200.00Published rate
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See a sample payer proposalCPT 45119 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45119 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 45119 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) |
| 45116-CPT | High | Proctectomy Partial W/ Anastomsis; Transsacral Approa Only (Kra, Proctectomy Partial With Anastomosis; Transsacral Approach Only (Kra |
| 45119-CPT | High | Remove Rectum W Reservoir, Proctectomy Combined Abdominoperineal Pull Through Procedure Eg Colo Anal Anastomosis With Creation Of Colonic Reservoir Eg J Pouch With Diverting Enterostomy When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45119. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45119 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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