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See a sample rate comparisonCPT 45321 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.
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 | None 33 - Preventive Services 22 - Increased Procedural Services 51 - Multiple procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 45321 |
| Medicaid Fee Schedule | View Medicaid rates for 45321 |
National average reimbursement for CPT 45321 by major payers:
$144.48
$137.05
$143.24
$169.53
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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 CPT 45321 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 45321 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 |
|---|---|---|
| 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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