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See a sample rate comparisonCPT 45562 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.
Exploration, Repair, And Presacral Drainage For Rectal Injury
| 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 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45562 |
| Medicaid Fee Schedule | View Medicaid rates for 45562 |
National average reimbursement for CPT 45562 by major payers:
$1,383.08
$1,481.68
$1,559.27
$1,807.16
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CPT 45562
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$17,689.00Published rateSurgery Center Of Scottsdale, LLC, Mountain View Surgery Center Of Scottsdale
Surgery Center Of Scottsdale LLC
$983.00Published rateMiddlebrook Asc, LLC
Middlebrook Asc LLC
$681.00Published rateLakewood Asc, LLC
Lakewood Asc LLC
$443.00Published rateAmbulatory Surgery Center Of Tucson, Inc.
Ambulatory Surgery Center Of Tucson Inc
$100.00Published rate
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See a sample payer proposalCPT 45562 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45562 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 45562 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 |
|---|---|---|
| 45499-CPT | High | Unlisted Laproscopy Procedure Rectum |
| 45560-CPT | Moderate | Repair Rectum Bulge To Vagina, Surgery To Repair A Rectocele. This Is A Condition Where Tissue From The Wall Of The Rectum Bulges Into The Vagina. |
| 45562-CPT | High | Exploration, Repair, And Presacral Drainage For Rectal Injury |
| 45563-CPT | High | Rectal Injury Repair, Surgery To Explore And Repair Injury To Rectum. The Procedure Includes Creating A Connection Between A Portion Of The Colon And A Surgically Created Opening In The Abdominal Wall (Stoma). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45562. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45562 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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