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See a sample rate comparisonCPT 45321 Fee Schedule
Medicare rates as of October 2026
CPT 45321 is classified under Surgery, in the Surgical Procedures on the Digestive System subgroup.
Treatment Of Twisted Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure Treats A Section That Has Become Twisted.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 33 - Preventive Services 22 - Increased Procedural Services 51 - Multiple procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | $98.20 national non-facility rate (2026) · View Medicare rates for 45321 |
| Medicaid Fee Schedule | $77.33 median of the 8 states in the free preview · View Medicaid rates for 45321 |
National average reimbursement for CPT 45321 by major payers:
$144.48
BCBS / Anthem
$137.05
UnitedHealthcare
$143.24
Aetna
$169.53
Cigna
Compare published rates across providers.
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CPT 45321
5 of 25 sample ratesHigher to lower in this preview
Surgcenter Of Greater Dallas, LLC., Surgcenter Of Greater Dallas
Surgcenter Of Greater Dallas LLC
$3,150.00Published rateMaple Lawn Surgery Center
Maple Lawn Surgery Center, LLC
$2,101.00Published rateMarion Eye Surgery Center LLC
$1,080.00Published rateMesa Az Endoscopy Asc LLC, Desert Endoscopy Center
The Mesa Az Endoscopy Asc, LLC
$606.00Published rateShauna Funderburk
Deaconess Hospital Inc
$81.65Published rate
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See a sample payer proposalCPT 45321 vs. Other Surgical Procedures on the Digestive System Codes
The table lists codes related to 45321. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 45335-CPT | Moderate | Exam Left Colon With Scope, Exam Of The Left Side Of The Lower Colon Using A Flexible Scope Inserted Into The Rectum (Sigmoidoscopy). The Procedure Includes An Injection. |
| 45337-CPT | Low | Sigmoidoscopy Decompress, Sigmoidoscopy Flexible With Decompression For Pathologic Distention Eg Volvulus Megacolon Including Placement Of Decompression Tube When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45321. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45321 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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