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See a sample rate comparisonCPT 45320 Fee Schedule
Last Verified: September 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.
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 | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45320 |
| Medicaid Fee Schedule | View Medicaid rates for 45320 |
National average reimbursement for CPT 45320 by major payers:
$261.76
$272.04
$299.37
$179.83
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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 CPT 45320 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 45320 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 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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