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See a sample rate comparisonCPT 45800 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.
Close Rectovesical Fistula
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 45800 |
| Medicaid Fee Schedule | View Medicaid rates for 45800 |
National average reimbursement for CPT 45800 by major payers:
$1,536.68
$1,650.90
$1,692.32
$1,991.28
Compare published rates across providers.
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CPT 45800
5 of 25 sample ratesHigher to lower in this preview
Columbia North Hills Hospital Subsidiary Lp, Medical City North Hills
Columbia North Hills Hospital Subsidiary Lp
$10,364.00Published rateLebanon Endoscopy Center LLC, Lebanon Endoscopy Center
Lebanon Endoscopy Center LLC
$1,049.00Published rateSagamore Surgical Services, Inc.
$620.00Published rateGeorgia Surgical Centers Inc
$400.00Published rateSurgery Center Of St. Joseph, LLC
Surgery Center Of St Joseph LLC
$66.00Published rate
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See a sample payer proposalCPT 45800 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45800 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 45800 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 |
|---|---|---|
| 45120-CPT | High | Proctectomy Complete (For Con, Proctectomy Complete (For Congenital Megacolon) Abdominal And Perineal Approach With Pull-Throughprocedure And Anastomosis (Eg Swenson Duhamel Or Soave Type Operation) |
| 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). |
| 45800-CPT | High | Close Rectovesical Fistula |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45800 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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