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See a sample rate comparisonCPT 45900 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.
Repair Rectum That Slips Down, Procedure To Correct Rectal Prolapse (Condition Where The Walls Of The Rectum Fall Out Of Place And Protrude From The Anus).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45900 |
| Medicaid Fee Schedule | View Medicaid rates for 45900 |
National average reimbursement for CPT 45900 by major payers:
$271.86
$271.46
$290.73
$339.75
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CPT 45900
5 of 25 sample ratesHigher to lower in this preview
Northwest Surgery Center LLC, Foot & Ankle Surgery Center
$3,254.00Published rateMnh Gi Surgical Center LLC, Mnh Surgical Center
$967.00Published rateG A Endoscopy Center, LLC
G A Endoscopy Center LLC
$557.00Published rateSalubrious Asc, LLC
Salubrious Asc LLC
$389.00Published rateCertified Ambulatory Surgery Center, Casc
Certified Ambulatory Surgery Center
$169.00Published rate
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See a sample payer proposalCPT 45900 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45900 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 45900 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 |
|---|---|---|
| 45805-CPT | High | Repair Rectum/Bladder Passage, Surgery To Repair An Abnormal Passageway (Fistula) Between The Rectum And The Bladder. The Procedure Includes Creating A Connection Between A Portion Of The Colon And A Surgically Created Opening In The Abdominal Wall (Stoma). |
| 45820-CPT | High | Close Rectoureth Fistula |
| 45825-CPT | High | Repair Rectum/Urethra Passage, Surgery To Repair An Abnormal Passageway (Fistula) Between The Rectum And The Urethra. The Procedure Includes Creating A Connection Between A Portion Of The Colon And A Surgically Created Opening In The Abdominal Wall (Stoma). |
| 45900-CPT | Moderate | Repair Rectum That Slips Down, Procedure To Correct Rectal Prolapse (Condition Where The Walls Of The Rectum Fall Out Of Place And Protrude From The Anus). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45900 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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