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See a sample rate comparisonCPT 45309 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.
Colonoscopy To Remove Tissue, An Exam Of The Lower Part Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Removes Abnormal Tissue Growths Such As Tumors Or Polyps.
| 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 51 - Multiple procedures 59 - Distinct Procedural Service PT - Colorectal cancer screening test; converted to diagnostic test or other procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45309 |
| Medicaid Fee Schedule | View Medicaid rates for 45309 |
National average reimbursement for CPT 45309 by major payers:
$239.00
$258.05
$280.69
$165.96
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CPT 45309
5 of 25 sample ratesHigher to lower in this preview
Los Gatos Surgical Center, A California Limited Partnership
$3,933.00Published rateAdvanced Surgical Concepts LLC
$1,179.00Published ratePrince Frederick Surgery Center LLC
Prince Frederick Surgery Center, LLC
$773.00Published rateHogan Surgical Center, P. A.
Hogan Surgical Center P A
$525.00Published rateGabriel Ballinger
Deaconess Hospital Inc
$141.69Published rate
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See a sample payer proposalCPT 45309 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45309 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 45309 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 |
|---|---|---|
| 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. |
| 45307-CPT | Moderate | Remove Object From Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure Removes A Foreign Object. |
| 45308-CPT | Moderate | Colonoscopy To Remove Tissue, An Exam Of The Lower Part Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Removes Abnormal Tissue Growths Such As Tumors Or Polyps. |
| 45309-CPT | Moderate | Colonoscopy To Remove Tissue, An Exam Of The Lower Part Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Removes Abnormal Tissue Growths Such As Tumors Or Polyps. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45309. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45309 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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