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 |
| Medicare Fee Schedule | View Medicare rates for 45307 |
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 | $3624.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2353.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | 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 | $2388.00 | 1679644017 - FLATIRONS SURGERY CENTER, LLC, PEAK GASTROENTEROLOGY | 710864752 - (CO) FLATIRONS SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2795.00 | 1700661212 - PUYALLUP AMBULATORY SURGERY CENTER, LLC | 931376698 - (WA) PUYALLUP AMBULATORY SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $7408.95 | 1619096161 - THE WESTERN PENNSYLVANIA HOSPITAL, FORBES REGIONAL CAMPUS | 250969492 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $926.00 | 1679658710 - STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC, WILLS EYE SURGERY CENTER | 232981922 - (PA) STADIUM CAMPUS AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $3500.00 | 1508871211 - TEXAS DIGESTIVE DISEASE CENTER, LTD | 273578014 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2353.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2353.00 | 1063092047 - TAMPA BAY JOINT AND SPINE, LLC, TAMPA BAY JOINT AND SPINE SURGERY CENTER | 851259146 - (FL) TAMPA BAY JOINT AND SPINE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1971.00 | 1093079196 - MERCY HOSPITALS EAST COMMUNITIES, MERCY OUTPATIENTSURGERY CENTER WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $2044.00 | 1740831437 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $1751.00 | 1518300102 - SPRINGFIELD SURGERY CENTER, LLC | 461041413 - (NJ) SPRINGFIELD SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $868.00 | 1720081870 - ORTHOPAEDIC AMBULATORY SURGICAL INTERVENTION SERVICES, LLC, OASIS | 582398485 - (OH) ORTHOPAEDIC AMBULATORY SURGICAL INTERVENTION SERVICES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45307 | $496.00 | 1932268299 - PATRICK A CONARRO MD, D.B.A. SUMMIT SURGICAL ASC | 581903669 - (GA) PATRICK A CONARRO MD | GA | 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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