CPT 45171 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 45171 by major payers:
$748.76
$822.62
$868.76
$1,041.69
| 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 45171 | ||||||
United | 45171 | $1505.00 | 1821361130 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC SHOWLOW | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1045.00 | 1992875454 - ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC, THE ENDO CENTER OF ELGIN GASTROENTEROLOGY | 200916460 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $2859.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $2388.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $2353.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $2388.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364120432 - (IL) NORTH SHORE SAME DAY SURGERY LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1479.00 | 1508911728 - MINIMALLY INVASIVE SURGICAL AND NEUROSCIENCE LLC, DELAWARE OUTPATIENT CENTER FOR SURGERY | 161694674 - (DE) DELAWARE OUTPATIENT CENTER FOR SURGERY | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1733.00 | 1043690845 - UNION HILLS PAIN PARTNERS LLC, HONORHEALTH PAIN MANAGEMENT CENTER | 473325492 - (AZ) UNION HILLS PAIN PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1682.00 | 1124086608 - LUTHERAN CAMPUS ASC LLC, THE SURGERY CENTER AT LUTHERAN | 20749532 - (CO) LUTHERAN CAMPUS ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1840.00 | 1114302353 - POINT OF ROCKS SURGERY CENTER, LLC | 464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $2408.00 | 1346289428 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE SURGEONS SEATTLE ORTHOPEDIC CENTER-ASC | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1000.00 | 1205184603 - ST. LUKES SURGICAL AT THE VILLAGES, INC | 460659691 - (FL) ST LUKES SURGICAL AT THE VILLAGES INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1243.00 | 1497851893 - CHINIKO LLC, EYE SURGERY CENTER | 931234805 - (OR) CHINIKO LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $2388.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45171 | $1248.00 | 1003110792 - CREVE COEUR SURGERY CENTER, LLC, CITY PLACE SURGERY CENTER | 273332421 - (MO) CREVE COEUR SURGERY CENTER LLC | MO | 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 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.
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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