CPT 45349 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • PT - Colorectal cancer screening test; converted to diagnostic test or other procedure • 33 - Preventive Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45349 |
National average reimbursement for CPT 45349 by major payers:
$275.41
$279.61
$343.66
$358.24
| 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 45349 | ||||||
United | 45349 | $2307.00 | 1598270076 - BELTWAY SURGERY CENTERS, LLC, SAXONY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $425.00 | 1861449571 - KIRURGS, LLC, SURGEONS' SURGICAL CENTER | 522018568 - (MD) SURGEONS SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $750.00 | 1144590332 - HEALTHCARE PARTNERS ASC-LB, LLC, DAVITA MEDICAL ASC | 954628842 - (CA) HEALTHCARE PARTNERS ASCLB LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1137.00 | 1497706626 - CHICAGO PROSTATE CANCER SURGERY CENTER, LLC, DUPAGE MEDICAL GROUP SURGERY CENTER, WESTMONT | 204403852 - (IL) CHICAGO PROSTATE CANCER SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1200.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1714.00 | 1891701611 - ESSEX ENDOSCOPY CENTER LLC | 223777761 - (NJ) ESSEX ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $611.00 | 1154422541 - BRUNSWICK PAIN TREATMENT CENTER, LLC | 562441571 - (GA) BRUNSWICK PAIN TREATMENT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1258.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $450.00 | 1558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | 593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1938.00 | 1437427333 - TOWER CLOCK SURGERY CENTER LLC | 453636581 - (WI) TOWER CLOCK SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1017.00 | 1063514107 - OHIO SURGERY CENTER LLC | 870566551 - (OH) OHIO SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $601.00 | 1023043445 - AESTHETIC EYE ASSOCIATES, PS, ALLURE LASER CENTER & MEDISPA | 911577091 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $564.00 | 1548374267 - DALLAS SURGI CENTER, INC. | 752199927 - (TX) DALLAS SURGI CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $1405.00 | 1174708390 - ORTHOPAEDIC SPECIALTY SURGERY CENTER LLC, ORTHOPAEDIC & SPECIALTY SURGERY CENTER | 263119034 - (CT) ORTHOPAEDIC SPECIALTY SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45349 | $997.00 | 1619013455 - RUSH SURGICENTER AT THE PROFESSIONAL BUILDING LTD. PARTNERSHIP, RUSH SURGICENTER LTD. PARTNERSHIP | 363853026 - (IL) RUSH SURGICENTER, LTD. | IL | 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 45349 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45349 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 45349 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 |
|---|---|---|
| 45338-CPT | Moderate | Sigmoidoscopy, Flexible; With Removal Of Tumor(S), Polyp(S), Or Other Lesion(S) By Snare Technique |
| 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 |
| 45349-CPT | Moderate | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Endoscopic Mucosal Resection. |
| 45385-CPT | Moderate | Colonoscopy Flexible With Removal Of Tumor(S) Polyp(S) Or Other Lesion(S) By Snare Technique (Desc Revised 01/01/15) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45349. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45349 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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