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See a sample rate comparisonCPT 45303 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.
Exam Of Narrowed Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure Enlarges A Section That Has Become Narrowed.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45303 |
| Medicaid Fee Schedule | View Medicaid rates for 45303 |
National average reimbursement for CPT 45303 by major payers:
$970.51
$1,176.42
$1,259.48
$1,444.16
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CPT 45303
5 of 25 sample ratesHigher to lower in this preview
Lake Spivey Ambulatory Surgery Care, LLC, Spivey Station Surgery Center
Emory University
$3,188.00Published rateEdward Moore
Deaconess Hospital Inc
$1,613.18Published rateGainesville Endoscopy Center, LLC
Gainesville Endoscopy Center LLC
$1,276.00Published rateDermatology Associates Of Kentucky, Psc
Dermatology Associates Of Kentucky, P.S.C.
$792.59Published rateCentral Arkansas Surgery Center, LLC
Central Arkansas Surgery Center LLC
$449.00Published rate
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See a sample payer proposalCPT 45303 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45303 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 45303 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 |
|---|---|---|
| 45300-CPT | Low | Scope Exam Of Large Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure May Include Taking A Sample Of Tissue For Testing (Biopsy). |
| 45303-CPT | Moderate | Exam Of Narrowed Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure Enlarges A Section That Has Become Narrowed. |
| 45305-CPT | Moderate | Colonoscopy For Biopsy, An Exam Of The Lower Part Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Takes A Sample Of Tissue For Testing (Biopsy). |
| 45307-CPT | Moderate | Remove Object From Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure Removes A Foreign Object. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45303. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45303 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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