CPT 45350 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 | • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • SG - Scene to Hospital ESRD facility • 79 - Unrelated procedure - postop period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45350 |
National average reimbursement for CPT 45350 by major payers:
$686.15
$810.57
$801.05
$1,173.72
| 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 45350 | ||||||
United | 45350 | $820.00 | 1255332805 - PRAIRIELAND OUTPATIENT DIAGNOSTIC CENTER LLC, DIGESTIVE DISEASE ENDOSCOPY CENTER | 50540368 - (IL) PRAIRIELAND OUTPATIENT DIAGNOSTIC CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $394.00 | 1447218433 - LIBERTY EYE SURGICAL CENTER LLC | 200054137 - (PA) LIBERTY EYE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $1258.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $993.00 | 1710768783 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, ATLAS SURGERY CENTER | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $1258.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $4090.00 | 1184195877 - ALPINE SURGICENTER, LLC | 831318143 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $905.00 | 1003015843 - NORTHBAY PHYSICIAN'S SURGERY CENTER, L.L.C. | 203502901 - (CA) NORTHBAY PHYSICIANS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $1528.00 | 1356621239 - MIDLAND TEXAS SURGICAL CENTER, LLC, TEXAS SURGICAL CENTER, AN AFFILIATE OF MIDLAND MEMORIAL HOSPITAL | 453047741 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $700.00 | 1679605729 - METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC | 222306421 - (NJ) METROPOLITAN SURGICAL ASSOCIATES, INC. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $840.00 | 1538124490 - CITRUS REGIONAL SURGERY CENTER LP | 621510209 - (FL) CITRUS REGIONAL SURGERY CENTER LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $550.00 | 1215957816 - SURGERY CENTER OF CENTRAL VIRGINIA INC., D.B.A. EYE SURGERY CENTER | 541816412 - (VA) SURGERY CENTER OF CENTRAL VIRGINIA INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $1179.00 | 1285815522 - TLC ASC, LLC, KZMSS AGAIN, LLLP | 201952603 - (FL) TLC ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $1700.00 | 1255797726 - BLOOMFIELD ASC LLC | 474758895 - (CT) BLOOMFIELD ASC, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $805.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45350 | $925.00 | 1750874400 - DENVER DIAGNOSTIC ASC, LLC | 825510334 - (CO) DENVER DIAGNOSTIC ASC LLC | CO | 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 45350 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45350 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 45350 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 |
|---|---|---|
| 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 |
| 45349-CPT | Moderate | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Endoscopic Mucosal Resection. |
| 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 45350. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45350 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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