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See a sample rate comparisonCPT 45320 Fee Schedule
Medicare rates as of October 2026
CPT 45320 is classified under Surgery, in the Surgical Procedures on the Digestive System subgroup.
Proctosigmoidoscopy Ablate, 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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $245.83 national non-facility rate (2026) · View Medicare rates for 45320 |
| Medicaid Fee Schedule | $189.58 median of the 8 states in the free preview · View Medicaid rates for 45320 |
National average reimbursement for CPT 45320 by major payers:
$261.76
BCBS / Anthem
$272.04
UnitedHealthcare
$299.37
Aetna
$179.83
Cigna
Compare published rates across providers.
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CPT 45320
5 of 25 sample ratesHigher to lower in this preview
Austin Gi Surgicenter, LLC, Austin Endoscopy Center
Austin Gi Surgicenter LLC
$3,993.00Published rateBaptist Surgery And Endoscopy Centers, LLC, Baptist Health Endoscopy Center At Miami Beach
$1,954.00Published rateComprehensive Pain Asc, LLC
Comprehensive Pain Asc LLC
$1,250.00Published rateDoctors Hospital Surgery Center, L.P.
Doctors Hospital Surgery Center Lp
$1,001.00Published rateKristine Hays
Deaconess Hospital Inc
$151.38Published rate
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See a sample payer proposalCPT 45320 vs. Other Surgical Procedures on the Digestive System Codes
The table lists codes related to 45320. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 45317-CPT | Moderate | Proctosigmoidoscopy Bleed, Proctosigmoidoscopy Rigid With Control Of Bleeding Eg Injection Bipolar Cautery Unipolar Cautery Laser Heater Probe Stapler Plasma Coagulator |
| 45320-CPT | Moderate | Proctosigmoidoscopy Ablate, 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 |
| 45321-CPT | Low | Treatment Of Twisted Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure Treats A Section That Has Become Twisted. |
| 45338-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 45320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45320 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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