CPT 45307 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $204.75 Physician Fee Schedule |
National average reimbursement for CPT 45307 by major payers:
$232.55
$252.97
$280.08
$329.81
| 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 45307 | ||||||
United | 45307 | $2762.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1177.00 | 1255309951 - BAYFRONT SAME DAY SURGERY CENTER, LLC. | 845074208 - (FL) OHI WEST INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $3024.00 | 1962423574 - FULLERTON SURGICAL CENTER, LP, FULLERTON SURGICAL CENTER | 470927394 - (CA) FULLERTON SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2206.00 | 1144331760 - RESURGENS SURGERY CENTER LLC | 582397841 - (GA) RESURGENS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1198.00 | 1194233189 - CHAPIN ORTHOPEDIC SURGERY CENTER | 473916029 - (SC) CHAPIN ORTHOPEDIC SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1701.00 | 1770958522 - UCHEALTH AMBULATORY SURGERY CENTERS, LONGS PEAK SURGERY CENTER, LLC | 383984888 - (CO) UCHEALTH AMBULATORY SURGERY CENTERS | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $3993.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $975.00 | 1346322187 - XRS LLC, COLUMBUS PAIN INSTITUTE | 201384877 - (IN) XRS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1056.00 | 1548249675 - ENDOSCOPY CENTER OF SANTA FE LP, THE ENDOSCOPY CENTER OF SANTA FE | 621548645 - (NM) ENDOSCOPY CENTER OF SANTA FE LP | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1011.00 | 1326379967 - WEIR ASC, LLC, SOUTHWEST EYE SURGERY CENTER | 271659546 - (OK) WEIR ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2500.00 | 1780789024 - LINDEN SURGICAL CENTER, LLC | 223634504 - (NJ) LINDEN SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1662.00 | 1750862389 - PEDIATRIC AND ADULT SURGERY CENTER OF ATLANTA LLC | 831536863 - (GA) PEDIATRIC AND ADULT SURGERY CENTER OF ATLANTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $307.47 | 1346669496 - CARLOS OSORIO | 350593390 - DEACONESS HOSPITAL INC | OH | Pulmonary Disease Physician (207RP1001X) |
United | 45307 | $3777.00 | 1164732426 - NORWALK SURGERY CENTER, LLC | 272394942 - (CT) NORWALK SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $580.00 | 1023271459 - RIVERBEND AMBULATORY SURGERY CENTER LLC, DAY SURGERY AT RIVERBEND | 205575145 - (OR) RIVERBEND AMBULATORY SURGERY CENTER LLC | OR | 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 45307 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45307 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 45307 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 |
|---|---|---|
| 45100-CPT | Moderate | Biopsy Anorectal Wall Anal Appr |
| 45110-CPT | High | Proctectomy;Complete,Comb,1-2 Stg |
| 45300-CPT | Low | Proctosigmoidoscopy, Rigid; Diagnostic, With Or Without Collection Of Specimen(S) By Brushing Or Washing (Separate Procedure) |
| 45307-CPT | Moderate | Proctosigmoidoscopy; Remove Fb |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45307. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45307 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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