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See a sample rate comparisonCPT 45400 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Laparoscopy Surgical Proctopexy
| 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 AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45400 |
| Medicaid Fee Schedule | View Medicaid rates for 45400 |
National average reimbursement for CPT 45400 by major payers:
$1,377.01
$1,519.95
$1,624.62
$1,844.08
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CPT 45400
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Woodlands Parkway, LLC, Memorial Hermann Surgery Center Woodlands Parkway
$4,893.00Published rateHill Country Surgery Center, LLC, Surgery Center Of Boerne
Hill Country Surgery Center LLC
$1,274.00Published rateThe Center For Specialized Surgery, Lp
$650.00Published rateDialysis Access Center Of Cincinnati, Inc.
Dialysis Access Center Of Cincinnati Inc
$375.00Published rateDiscover Eye Surgery Center, LLC, Eye Surgery Center - The Cliffs
Discover Eye Surgery Center LLC
$75.00Published rate
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See a sample payer proposalCPT 45400 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45400 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 45400 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 |
|---|---|---|
| 45397-CPT | High | Lap Remove Rectum W Pouch, Laparoscopy Surgical Proctectomy Combined Abdominoperineal Pull Through Procedure Eg Colo Anal Anastomosis With Creation Of Colonic Reservoir Eg J Pouch With Diverting Enterostomy When Performed |
| 45400-CPT | High | Laparoscopy Surgical Proctopexy |
| 45402-CPT | High | Laparoscopy Surg; Proctopexy (For Prolapse) W/ Sigmoid Resecti, Laparoscopy Surgical; Proctopexy (For Prolapse) With Sigmoid Resecti |
| 45550-CPT | High | Repair Rectum Out Of Anus, Surgery To Repair Rectal Prolapse (Condition Where Rectum Falls Out Of Place And Presses On Anus Wall). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45400 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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