CPT 45399 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 45399 by major payers:
$236.75
$1,090.74
$2,081.00
$16,778.34
| 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 45399 | ||||||
United | 45399 | $517.00 | 1588274963 - WILMINGTON EYE SURGERY CENTER, LLC | 842465908 - (NC) WILMINGTON EYE SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $2392.00 | 1396700407 - ARLINGTON SURGERY CENTER, LLC, ARLINGTON SURGERY CENTER ASSOCIATES, LP | 752055800 - (TX) ARLINGTON SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $425.00 | 1578558078 - KINGSPORT ENDOSCOPY CORPORATION | 61249637 - (TN) KINGSPORT ENDOSCOPY CORPORATION | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $675.00 | 1881125870 - RENAL ASSOCIATES, P.A. | 742083988 - (TX) RENAL ASSOCIATES, PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $1258.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $394.00 | 1447218433 - LIBERTY EYE SURGICAL CENTER LLC | 200054137 - (PA) LIBERTY EYE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $564.00 | 1750468583 - TEXAS EYE SURGERY CENTER, LLC | 202928367 - (TX) TEXAS EYE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $1433.00 | 1922165901 - CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY, THE ROBERT ZUBOWSKI CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY | 200768828 - (NJ) CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $2933.18 | 1720334097 - PACIFIC SURGERY CENTER, LLC | 460598503 - PACIFIC SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $633.00 | 1568445062 - EYE SURGERY & LASER CENTER OF WISCONSIN LLC | 461222222 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $478.00 | 1780661967 - CJ ELMWOOD PARTNERS L P | 911793912 - CJ ELMWOOD PARTNERS L P | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $578.00 | 1093764045 - GASTROENTEROLOGY OF INDIANAPOLIS PC, DIGESTIVE HEALTH CENTER | 351641181 - (IN) GASTROENTEROLOGY OF INDIANAPOLIS, P . C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $864.00 | 1689326670 - PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC, PRISMA HEALTH ORTHOPEDIC SURGERY CENTER | 873101776 - (SC) PRISMA HEALTH AMBULATORY SURGERY CENTERSMIDLANDS LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $832.00 | 1841507266 - SOUTH PORTLAND SURGICAL CENTER LLC, SOUTH PORTLAND SURGICAL CENTER | 800461691 - (OR) SOUTH PORTLAND SURGICAL CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45399 | $443.00 | 1538113238 - ADVANCED LASER & SURGICENTER OF ARIZONA, PC | 721546625 | AZ | 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 45399 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45399 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 45399 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 |
|---|---|---|
| 45379-CPT | Moderate | Removal Of Foreign Bodies In Large Bowel (Colon) Using An Endoscope (Colonoscopy) |
| 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 |
| 45399-CPT | Moderate | Other Procedure On Large Bowel |
| 45400-CPT | High | Laparoscopy Surgical Proctopexy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45399. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45399 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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