CPT 45346 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • PT - Colorectal cancer screening test; converted to diagnostic test or other procedure • 59 - Distinct Procedural Service |
| Complexity Level | High |
| CMS | $2,083.12 Physician Fee Schedule |
National average reimbursement for CPT 45346 by major payers:
$2,095.09
$2,474.88
$3,120.10
$3,409.16
| 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 45346 | ||||||
United | 45346 | $1955.00 | 1992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $680.00 | 1376542076 - FREDERICK SURGICAL CENTER, LLC | 521652443 - (MD) FREDERICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $512.00 | 1225517279 - ORLANDO OUTPATIENT SURGERY CENTER LLC | 821372628 - (FL) ORLANDO OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $2573.00 | 1588681373 - CONSTITUTION SURGERY CENTER EAST LLC | 61574704 - (CT) CONSTITUTION EYE SURGERY CENTER EAST, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $2200.00 | 1871519314 - NORTHERN LITHO INC | 161511455 - (FL) NORTHERN LITHO, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $643.00 | 1306274097 - INTERVENTIONAL PAIN MANAGEMENT LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $803.00 | 1033105960 - SURGERY CENTER OF OAK RIDGE, LLC, ADVANCED FAMILY SURGERY CENTER | 621801416 - (TN) ADVANCED FAMILY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $1608.00 | 1700807617 - ENDOSCOPY CENTER OF THE ROCKIES LLC, ENDOSCOPY CENTER OF THE ROCKIES LAFAYETTE | 841562782 - (CO) ENDOSCOPY CENTER OF THE ROCKIES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $626.00 | 1538101373 - DANVILLE POLYCLINIC, LTD, DANVILLE POLYCLINIC LTD ASTC | 370967248 - (IL) DANVILLE POLYCLINIC, LTD. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $1000.00 | 1538664644 - TAMPA BAY SURGERY CENTER ASSOCIATES LTD, CENTER FOR ADVANCED SURGICAL SPECIALIST | 593210851 - (FL) TAMPA BAY SURGERY CENTER ASSOC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $512.00 | 1578917035 - HABANA AMBULATORY SURGERY CENTER LLC | 475162374 - (FL) HABANA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $913.00 | 1972758183 - DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC | 260448163 - (CT) DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $448.00 | 1548359037 - SURGERY CENTER OF BRANSON, SURGERY CENTER OF BRANSON LLC | 680627781 - (MO) SURGERY CENTER OF BRANSON | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $1297.00 | 1518323435 - SOUTHTOWNS SURGERY CENTER LLC | 464742028 - (NY) SOUTHTOWNS SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45346 | $5049.08 | 1255473625 - HILARY NWOSU | 350593390 - DEACONESS HOSPITAL INC | CA | Emergency Medicine Physician (207P00000X) |
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 45346 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45346 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 45346 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 |
|---|---|---|
| 45333-CPT | Moderate | Sigmoidoscopy Flexible; With Removal Of Tumor(S) Polyp(S) Or Other Lesion(S) By Hot Biopsy Forceps(Desc Revised 01/01/15) |
| 45338-CPT | Moderate | Sigmoidoscopy, Flexible; With Removal Of Tumor(S), Polyp(S), Or Other Lesion(S) By Snare Technique |
| 45346-CPT | High | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Ablation Of Tumor(S), Polyp(S), Or Other Lesions(S) Includ |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45346. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45346 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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