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See a sample rate comparisonCPT 45123 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.
Protectomy, Partial, Without Anastomosis, Perineal Approach
| 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 AS - PA/NP/CNS assistant at surgery 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45123 |
| Medicaid Fee Schedule | View Medicaid rates for 45123 |
National average reimbursement for CPT 45123 by major payers:
$1,391.27
$1,476.05
$1,530.99
$1,786.48
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CPT 45123
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Katy LLP
$8,087.00Published rateTexas Digestive Disease Center, Ltd
$4,704.00Published rateSt. Louis Women'S Surgery Center, LLC, St. Louis Multispecialty Surgery Center
St Louis Womens Surgery Center LLC
$3,500.00Published rateWest Asc, LLC, Camillus Surgery Center
West Asc, LLC Dba Camillus Surgery Center
$1,752.00Published rateBoston Ivf, Inc., The Surgery Center Of Waltham
Boston Ivf, LLC
$177.00Published rate
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See a sample payer proposalCPT 45123 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45123 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 45123 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 45123. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45123 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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