Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 45120 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 Complete (For Con, Proctectomy Complete (For Congenital Megacolon) Abdominal And Perineal Approach With Pull-Throughprocedure And Anastomosis (Eg Swenson Duhamel Or Soave Type Operation)
| 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 58 - Staged or related procedure during postoperative period 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45120 |
| Medicaid Fee Schedule | View Medicaid rates for 45120 |
National average reimbursement for CPT 45120 by major payers:
$1,984.31
$2,116.89
$2,206.83
$2,537.71
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 45120.
CPT 45120
5 of 25 sample ratesHigher to lower in this preview
Bjosc, LLC, Bjosc, LLC @ Westwood
Bjosc LLC
$3,201.00Published rateSurgery Center Of Scottsdale, LLC, Mountain View Surgery Center Of Phoenix
Surgery Center Of Scottsdale LLC
$1,064.00Published rateApollo Ambulatory Surgery Center, LLC
Apollo Ambulatory Surgery Center LLC
$867.00Published rateLittleton Day Surgery Center LLC
Littleton Day Surgery Center
$555.00Published rateTruxtun Surgery Center Inc
Truxtun Surgery Center, Inc.
$251.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 45120 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45120 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 45120 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 |
|---|---|---|
| 45120-CPT | High | Proctectomy Complete (For Con, Proctectomy Complete (For Congenital Megacolon) Abdominal And Perineal Approach With Pull-Throughprocedure And Anastomosis (Eg Swenson Duhamel Or Soave Type Operation) |
| 45121-CPT | High | Removal Of Rectum And Colon, Proctectomy Complete For Congenital Megacolon Abdominal And Perineal Approach With Subtotal Or Total Colectomy With Multiple Biopsies |
| 45123-CPT | High | Protectomy, Partial, Without Anastomosis, Perineal Approach |
| 45130-CPT | High | Remove Rectum Out Of Anus, Removal Of Complete Rectal Prolapse (Condition Where Wall Of Rectum Falls Out Of Place And Protrudes From Anus). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45120 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 45120) and we'll show you how you compare in 15 minutes or less.