Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 45399 Fee Schedule
Last Verified: October 2026
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.
Surgery Or Exam On Colon, A Procedure Performed On The Colon.
| 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 |
| Medicare Fee Schedule | View Medicare rates for 45399 |
| Medicaid Fee Schedule | View Medicaid rates for 45399 |
National average reimbursement for CPT 45399 by major payers:
$236.75
$1,090.74
$2,081.00
$15,809.31
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 45399.
CPT 45399
5 of 25 sample ratesHigher to lower in this preview
The Vancouver Clinic Inc Ps, Salmon Creek 2 Ambulatory Surgery Center
The Vancouver Clinic, Inc., Ps
$1,285.00Published rateSurgcenter Clearwater, LLC, Surgcenter Dunedin
Surgcenter Clearwater LLC
$1,179.00Published rateWellness Ambulatory Surgery Center, LLC
Wellness Ambulatory Surgery Center LLC
$692.00Published rateWilmington Eye Surgery Center, LLC
Wilmington Eye Surgery Center LLC
$517.00Published rateThe Surgery Center Of The Villages, LLC, The Surgery Center Of The Villages
The Surgery Center Of The Villages LLC
$340.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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 | Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexure Withremoval Of Foreign Body Colonoscopy Flexible Proximal To Splenic Flexure With |
| 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 | Surgery Or Exam On Colon, A Procedure Performed On The Colon. |
| 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 45399) and we'll show you how you compare in 15 minutes or less.