CPT 45317 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 | • 11 - Office • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45317 |
National average reimbursement for CPT 45317 by major payers:
$251.45
$270.02
$298.27
$354.79
| 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 45317 | ||||||
United | 45317 | $363.00 | 1235105248 - GURLEY SURGERY CENTER, THE GYN CENTER | 621159796 - (TN) GURLEY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1258.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $2575.00 | 1154785848 - PROSPECT CCMC, LLC | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $337.32 | 1346209798 - VERNON TAYLOR | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 45317 | $772.00 | 1700842358 - THE EYE SURGERY CENTER OF THE CAROLINAS LP | 205562797 - (NC) THE EYE SURGERY CENTER OF THE CAROLINAS LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1123.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $664.00 | 1689605826 - LAUREL SURGERY & ENDOSCOPY CENTER, LLC | 412044822 - (MS) LAUREL SURGERY AND ENDOSCOPY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1504.00 | 1972874907 - CAPITAL CITY SURGERY CENTER, LLC | 260804803 - (NC) CAPITAL CITY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1276.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $2923.75 | 1003807835 - LAKEVIEW SURGERY CENTER LC | 421516120 - (IA) LAKEVIEW SURGERY CENTER LC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1010.00 | 1174197990 - KANSAS CITY SURGERY CENTER, LLC | 853624014 - (KS) KANSAS CITY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $489.00 | 1861089666 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC ASC TUCSON 5TH ST | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $601.00 | 1679544290 - KEYSTONE SURGERY CENTER, LTD | 43712391 - (PA) KEYSTONE SURGERY CENTER LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1743.00 | 1396784252 - FRONTENAC AMBULATORY SURGERY & SPINE CARE CENTER LP, FRONTENAC SURGERY & SPINE CARE CENTER | 205953268 - (MO) FRONTENAC AMBULATORY SURGERY SPINE CARE CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45317 | $1323.00 | 1386721249 - ALLIED PHYSICIANS SURGERY CENTER, LLC | 352057452 - (IN) ALLIED PHYSICIANS SURGERY CENTER LLC | IN | 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 45317 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45317 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 45317 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 |
|---|---|---|
| 45317-CPT | Moderate | Proctosigmoidoscopy, Rigid; With Control Of Bleeding (Eg, Injection, Bipolar Cautery, Unipolar Cautery, Laser, Heater Probe, Stapler, Plasma Coagulator) |
| 45320-CPT | Moderate | Proctosigmoidoscopy, Rigid; With Ablation Of Tumor(S), Polyp(S), Or Other Lesion(S) Not Amenable To Removal By Hot Biopsy Forceps, Bipolar Cautery Or Snare Technique (Eg, Laser) |
| 45330-CPT | Low | Sigmoidoscopy Flexible; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Separate Procedure) (Desc Revised 01/01/15) |
| 45334-CPT | Moderate | Sigmoidoscopy Flexible; With Control Of Bleeding Any Method (Desc Revised 01/01/15) Laser Heater Probe Stapler Plasma Coagulator) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45317. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45317 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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