CPT 45389 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 |
| Common Modifiers | • None • 52 - Reduced Services • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $276.24 Physician Fee Schedule |
National average reimbursement for CPT 45389 by major payers:
$395.27
$416.67
$427.01
$511.59
| 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 45389 | ||||||
United | 45389 | $500.00 | 1871941468 - AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | 812463581 - (MD) AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $1233.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $1849.00 | 1578566758 - ADVANCED AMBULATORY SURGICAL CARE, LP, ADVANCED SURGICAL CARE | 203833272 - (MO) ADVANCED AMBULATORY SURGICAL CARE LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $565.00 | 1407004534 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $589.00 | 1891722609 - EYE MDS OF PUGET SOUND PLLC, NARROWS EYE SURGERY CENTER | 43700768 - (WA) EYE M.D.S OF PUGET SOUND, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $760.00 | 1316191430 - LAREDO DIGESTIVE HEALTH CENTER LLC | 261286495 - (TX) LAREDO DIGESTIVE HEALTH CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $460.00 | 1033560420 - ABINGDON SURGICAL CENTER PC | 813054896 - (MD) ABINGDON SURGICAL CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $1275.00 | 1346773421 - WOMEN'S CARE FLORIDA LLC, WOMEN'S CARE FLORIDA SURGICAL CENTER | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $745.00 | 1396238010 - WICHITA NEPHROLOGY GROUP, PA, REVASK SURGERY CENTER LLC | 481080103 - (KS) WICHITA NEPHROLOGY GROUP, P.A. | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $376.00 | 1134293814 - PLYMOUTH LASER CENTER, P.C., PLYMOUTH LASER & SURGICAL CENTER | 43292630 - (MA) PLYMOUTH LASER CENTER PC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $2279.00 | 1629510326 - COLLEGE PARK ENDOSCOPY CENTER, LLC, COLLEGE PARK SURGERY CENTER | 474427740 - (KS) COLLEGE PARK ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $1258.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $643.00 | 1760473425 - BECKLEY SURGERY CENTER, INC | 550764318 - (WV) BECKLEY SURGERY CENTER INC | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $1000.00 | 1699745067 - NIAGARA HEALTH CENTER, INC | 391847009 - (WI) NIAGARA HEALTH CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45389 | $1258.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | 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 45389 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45389 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 45389 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) |
| 45350-CPT | Moderate | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Band Ligations(S) (Eg, Hemorrhoids). |
| 45389-CPT | Moderate | Colonoscopy, Flexible; Diagnostic, Including Collection Of Specimens By Brushing Or Washing, When Performed, With Endoscopic Stent Placement Includes Pre And Post Dilation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45389. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45389 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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