CPT 45330 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 | Endoscopy Procedures on the Rectum Surgical Procedures on the Colon and Rectum |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 45330 |
National average reimbursement for CPT 45330 by major payers:
$197.56
$210.43
$245.49
$113.58
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 45330 | $117.69 | 1780625038 - ANNA LEE | 320026719 - (NJ) HEALTH FIRST MEDICAL ASSOCIATES LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $127.94 | 1063684702 - EMILY FELZENBERG | 203719139 - (NJ) HIGHLAND PHYSICIAN SERVICES PA | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $109.77 | 1437176088 - VINOD SANCHETI | 223804077 - (NJ) VINOD SANCHETI MD PA | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $426.26 | 1346215126 - LISA RAACKE | 800886397 | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $392.95 | 1932168523 - ANGEL LAZO | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $353.66 | 1851312656 - SAMIR JAIN | 223316007 - BARNABAS HEALTH MEDICAL GROUP P C | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $123.02 | 1477558518 - CHARLES PEEPLES | 223205490 - (NJ) EATONTOWN MEDICAL ASSOCIATES PA | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $121.58 | 1841327384 - MAGDA ERAIBA | 475347946 - (NJ) WAYNE MEDICAL HEALTH PROFESSIONAL CORPORATION | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $84.98 | 1831122928 - WHITING MEDICAL ASSOCIATES, LLC | 222266685 - (NJ) WHITING MEDICAL ASSOCIATES LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $127.94 | 1275730053 - SUJATHA MUPPALA | 471099524 - (NJ) PRIORITY HEALTH ASSOCIATES LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $185.66 | 1083662589 - HAMID MAHMUD | 811200310 - (NJ) CAPITAL HEALTH MULTISPECIALTY GROUP | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $218.00 | 1205221199 - MAURICE HINSON | 113167120 | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $109.77 | 1376598136 - YELENA BIRGER | 1376598136 - (NJ) YELENA BIRGER | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $447.66 | 1669660627 - NISHAL RAVINDRAN | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | NJ | Internal Medicine Physician (207R00000X) |
United | 45330 | $138.63 | 1104263722 - MOHAMMAD ANWAR | 462019440 - AZZ MEDICAL ASSOCIATES PC | NJ | Internal Medicine Physician (207R00000X) |
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 45330 vs. Other Surgical Procedures on the Colon and Rectum Codes
The CPT 45330 code is part of the Endoscopy Procedures on the Rectum services used for Surgical Procedures on the Colon and Rectum. 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 45330 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 |
|---|---|---|
| 45330-CPT | Low | Scope Exam Of Large Intestine, An Exam Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure May Include Taking A Sample Of Tissue For Testing (Biopsy). |
| 45333-CPT | Moderate | Sigmoidoscopy Flexible With, Sigmoidoscopy Flexible With Removal Of Tumor(S)Polyp(S)Or Other Lesion(S) By Hot Biopsy Forceps Or Bipolar Cautery Sigmoidoscopy Flexible Wit H Removal Of Tumor(S) Polyp(S) |
| 45334-CPT | Moderate | Intestinal Bleeding Scope Exam, An Exam Of The Lower Part Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Treats Bleeding. |
| 45346-CPT | High | 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 45330. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45330 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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