CPT 45327 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • AG - Primary physician • 78 - Return to OR - related procedure |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 45327 |
National average reimbursement for CPT 45327 by major payers:
$156.45
$157.08
$162.96
$194.66
| 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 45327 | ||||||
United | 45327 | $3570.00 | 1295176139 - LOWCOUNTRY AMBULATORY CENTER, LLC | 274109893 - (SC) LOWCOUNTRY AMBULATORY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $2492.00 | 1073039657 - UNIVERSITY ORTHOPEDICS, INC., UOI-EAST BAY SURGERY CENTER | 873506992 | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $678.00 | 1801993217 - EYE PHYSICIANS OF SUSSEX COUNTY, EYE PHYSICIANS OF SUSSEX COUNTY SURGICAL SUITE | 222172159 - (NJ) EYE PHYSICIANS OF SUSSEX COUNTY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $800.00 | 1881875227 - SKIN & MOHS SURGERY CENTER, LLC | 431823843 - SKIN MOHS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $3570.00 | 1083624670 - PRESCOTT OUTPATIENT SURGICAL CENTER LLC | 860548048 - (AZ) PRESCOTT OUTPATIENT SURGICAL CENTER, LP | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1650.00 | 1760807127 - PHYSICIANS SURGERY CENTER AT GLENDALE ADVENTIST, LLC | 464085815 - (CA) PHYSICIANS SURGERY CENTER AT GLENDALE ADVENTIST LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1334.00 | 1649735861 - KURESMART PAIN MANAGEMENT SURGERY CENTER-CATONSVILLE LLC, CLEARWAY SURGERY CENTER OF CATONSVILLE | 832414671 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCATONSVILLE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $724.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $6285.00 | 1861657256 - INDIANA ENDOSCOPY CENTERS LLC | 208398421 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1895.00 | 1134590912 - SLENT INVESTMENTS, LLC, SLENT SURGERY CENTER | 472307119 - (LA) SLENT INVESTMENTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $3623.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1650.00 | 1306993464 - PACIFIC HILLS SURGERY CENTER LLC | 800180491 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1820.00 | 1558339424 - PREMIER SURGERY CENTER | 352206509 - (CA) PREMIPREMIER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $9100.00 | 1225064876 - ROCK HILL SURGERY CENTER, LLC, CAROLINA SURGICAL CENTER | 752562111 - (SC) ROCK HILL SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $3500.00 | 1750823886 - LAKE ENDOSCOPY CENTER, LLC | 814225104 - (FL) LAKE ENDOSCOPY CENTER LLC | FL | 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 45327 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45327 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 45327 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 |
|---|---|---|
| 45327-CPT | Low | Proctosigmoidoscopy, Rigid; With Transendoscopic Stent Placement |
| 45342-CPT | Moderate | Sigmoidoscopy, Flexible; With Transendoscopic Ultrasound Guided Intramural Or Transmural Fine Needle Aspiration/Biopsy(S) |
| 45347-CPT | Moderate | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimens By Brushing Or Washing, When Performed With Placement Of Endoscopic Stent Includes Pre And Post-Dilat |
| 45350-CPT | Moderate | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Band Ligations(S) (Eg, Hemorrhoids). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45327. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45327 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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