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See a sample rate comparisonCPT 45121 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.
Removal Of Rectum And Colon, Proctectomy Complete For Congenital Megacolon Abdominal And Perineal Approach With Subtotal Or Total Colectomy With Multiple Biopsies
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45121 |
| Medicaid Fee Schedule | View Medicaid rates for 45121 |
National average reimbursement for CPT 45121 by major payers:
$2,200.61
$2,311.77
$2,406.91
$2,824.85
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CPT 45121
5 of 25 sample ratesHigher to lower in this preview
Monterey Peninsula Surgery Center LLC
Monterey Peninsula Surgery Center, LLC
$6,343.00Published rateGeorgia Spine Surgery Center, LLC, Gns Surgery Center
Georgia Spine Surgery Center, LLC
$1,234.00Published rateBelmar Ambulatory Surgical Center, LLC
Belmar Ambulatory Surgical Center LLC
$760.00Published rateColumbus Endoscopy Center, Inc
Columbus Endoscopy Center Inc
$499.00Published rateArizona Surgical Specialists Center, LLC, Arizona Surgical Specialsts Center West Phoenix
Arizona Surgical Specialists Center LLC
$105.00Published rate
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See a sample payer proposalCPT 45121 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45121 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 45121 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 |
| 45126-CPT | High | Pelvic Exenteration, Pelvic Exenteration For Colorectal Malignancy With Proctectomy With Or Without Colostomy With Removal Of Bladder And Ureteral Transplantations And Or Hysterectomy Or Cervicectomy With Or Without Removal Of Tube S With Or Without Removal Of Ovary S Or Any Combination Thereof |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45121. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45121 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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