CPT 45119 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 |
| Common Modifiers | • None • 22 - Increased Procedural Services • 80 - Assistant surgeon |
| Complexity Level | High |
| CMS | $1,807.52 Physician Fee Schedule |
National average reimbursement for CPT 45119 by major payers:
$2,360.66
$2,567.53
$2,620.41
$3,128.05
| 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 45119 | ||||||
United | 45119 | $433.00 | 1417904756 - METROPOLITAN MEDICAL CENTER, LLC | 202804280 - (WI) METROPOLITAN MEDICAL CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $675.00 | 1285825075 - SUNNYSIDE SURGERY CENTER, LLC | 201164055 - (ID) SUNNYSIDE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $983.00 | 1558879684 - DELAWARE RIVER SURGICAL SUITES, LLC | 822713553 - (PA) BUCKS COUNTY SURGICAL SUITES | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $410.00 | 1619291192 - DALLAS IVF SURGERY CENTER, LLC, DALLAS IVF SURGERY CENTER | 263473774 - (TX) DALLAS IVF SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $722.00 | 1821285073 - GLENDORA CA ENDOSCOPY ASC LP, GLENDORA DIGESTIVE DISEASE INSTITUTE | 205732678 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $983.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $459.00 | 1396022257 - RIDGECREST SPECIALTY SURGERY CENTER A PROFESSIONAL CORPORATION | 453602999 - (CA) RIDGECREST SPECIALTY SURGERY CENTER A PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $163.00 | 1003887225 - CENTRAL TEXAS ENDOSCOPY CENTER LLC, CENTRAL TEXAS ENDOSCOPY CENTER | 742863853 - (TX) CENTRAL TEXAS ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $1118.00 | 1528027026 - VIRGINIA BEACH AMBULATORY SURGERY CENTER | 541448218 - (VA) VIRGINIA BEACH AMBULATORY SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $500.00 | 1881658524 - CUMBERLAND VALLEY SURGERY CENTER, LLC | 753079478 - (MD) CUMBERLAND VALLEY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $758.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $210.00 | 1790167740 - TIDALHEALTH SURGERY CENTER, LLC | 474184623 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $800.00 | 1154593481 - RANCHO MIRAGE SURGERY CENTER, LLC, RANCHO MIRAGE SURGERY CENTER | 262136928 - (CA) RANCHO MIRAGE SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $476.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45119 | $600.00 | 1912412420 - GALEA CENTER, LLC., GALEA CENTER FOR ADVANCED SURGERY | 821939476 - (CA) GALEA CENTER LLC | CA | 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 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 | Proctectomy W Part Resect Rectum |
| 45112-CPT | High | Proctectmy,Comb.Pull-Thru Proc,1-2 |
| 45114-CPT | High | Proctectomy W Anastomos Abd+Transac |
| 45119-CPT | High | 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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