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See a sample rate comparisonCPT 45171 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Xcision Of Rectal Tumor Transanal Approa; Not Inclu Muscularis, Excision Of Rectal Tumor Transanal Approach; Not Including Muscularis
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45171 |
| Medicaid Fee Schedule | View Medicaid rates for 45171 |
National average reimbursement for CPT 45171 by major payers:
$748.76
$822.62
$868.76
$1,019.91
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CPT 45171
5 of 25 sample ratesHigher to lower in this preview
Central Louisiana Ambulatory Surgical Center LLC
Central Louisiana Surgical Hospital, LLC
$4,111.00Published rateGardendale Surgical Associates, LLC
Gardendale Surgical Associates
$2,388.00Published ratePoint Of Rocks Surgery Center, LLC
$1,840.00Published rateCreve Coeur Surgery Center, LLC, City Place Surgery Center
Creve Coeur Surgery Center LLC
$1,248.00Published rateMetropolitan Ambulatory Urologic Institute, L.L.C.
Metropolitan Ambulatory Urologic Institute LLC
$494.00Published rate
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See a sample payer proposalCPT 45171 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45171 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 45171 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 |
|---|---|---|
| 45160-CPT | High | Xcision Of Rectal Tumor By Proctotomy Transsacral/Transcoccyge, Excision Of Rectal Tumor By Proctotomy Transsacral Or Transcoccygeal |
| 45171-CPT | Moderate | Xcision Of Rectal Tumor Transanal Approa; Not Inclu Muscularis, Excision Of Rectal Tumor Transanal Approach; Not Including Muscularis |
| 45172-CPT | Moderate | Xcision Of Rectal Tumor Transanal Approa; Inclu Muscularis Pro, Excision Of Rectal Tumor Transanal Approach; Including Muscularis Pro |
| 45190-CPT | Moderate | Destruction Rectal Tumor, Destruction Of Rectal Tumor Eg Electrodesiccation Electrosurgery Laser Ablation Laser Resection Cryosurgery Transanal Approach |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45171. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45171 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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