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 |
| CMS | $114.83 Physician Fee Schedule |
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 | $2200.00 | 1124093588 - UROLOGY SURGERY CENTER OF SAVANNAH, LLLP, UROLOGY SURGERY CENTER, LLP | 582511751 - (GA) UROLOGY SURGERY CENTER OF SAVANNAH LLLP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $2703.00 | 1548322829 - GASTROINTESTINAL MEDICAL CENTER | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1349.00 | 1134663677 - CASTLE HILLS SURGICARE, LLC | 813020487 - (TX) CASTLE HILLS SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $3976.00 | 1255373601 - CHESTERFIELD AMBULATORY SURGERY CENTER LP, CHESTERFIELD SURGERY CENTER | 203834076 - (MO) CHESTERFIELD AMBULATORY SURGERY CENTER LP | MO | 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 | $2538.00 | 1093146771 - NORTHWEST COMMUNITY DAY SURGERY CENTER II LLC | 300798249 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $3976.00 | 1760818710 - YORK COUNTY OUTPATIENT ENDOSCOPY CENTER LLC | 463366385 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $2117.00 | 1932430816 - SURGCENTER OF GREENBELT, LLC | 270408064 - (MD) SURGCENTER OF GREENBELT LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $2300.00 | 1801185665 - PERSEPOLIS GROUP LLC | 273653631 - (CA) PERSEPOLIS GROUP LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $1650.00 | 1306993464 - PACIFIC HILLS SURGERY CENTER LLC | 800180491 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $614.00 | 1437232758 - SHADY GROVE REPRODUCTIVE SCIENCE CENTER PC, SGFC SURGERY CENTER | 208131466 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $2392.00 | 1659505857 - HASBROUCK HEIGHTS SURGERY CENTER, LLC | 264379508 - (NJ) HASBROUCK HEIGHTS SURGERY CENT | NJ | 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 | $5202.00 | 1902877715 - AMBULATORY SURGICAL CENTER OF MORRIS COUNTY LLC, RIDGEDALE SURGERY CENTER | 223104481 - (NJ) AMBULATORY SURGICAL CENTER OF MORRIS COUNTY, INC. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45327 | $3976.00 | 1669574539 - MANCHESTER SURGERY CENTER, LLC | 205953313 | MO | 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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