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See a sample rate comparisonCPT 45910 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.
Dilation Of Rectal Stricture (Sepa Proc) Under Anesthe Oth, Dilation Of Rectal Stricture (Separate Procedure) Under Anesthesia Oth
| 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 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45910 |
| Medicaid Fee Schedule | View Medicaid rates for 45910 |
National average reimbursement for CPT 45910 by major payers:
$248.32
$266.79
$281.42
$316.08
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CPT 45910
5 of 25 sample ratesHigher to lower in this preview
Npi Surgery Center LLC
$2,933.18Published rateAdvanced Surgery Center Of Tampa, LLC
$1,233.00Published rateKaty Asc, Lp, Advanced Cardiovascular & Surgery Center At Methodist West Houston
$819.50Published rateHealth & Wellness Surgery Center, Tower Surgery Center
Health Wellness Surgery Center
$580.00Published rateConway Ambulatory Surgery Center, LLC
Conway Ambulatory Surgery Center LLC
$404.00Published rate
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See a sample payer proposalCPT 45910 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45910 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 45910 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 |
|---|---|---|
| 45905-CPT | Moderate | Dilation Of Anal Sphincter (Sepa Proc) Under Anesthe Other, Dilation Of Anal Sphincter (Separate Procedure) Under Anesthesia Other |
| 45910-CPT | Moderate | Dilation Of Rectal Stricture (Sepa Proc) Under Anesthe Oth, Dilation Of Rectal Stricture (Separate Procedure) Under Anesthesia Oth |
| 45990-CPT | Low | Anorectal Exam Surg Requir Anesthe (Gnral Spinal Or Ep, Anorectal Exam Surgical Requiring Anesthesia (General Spinal Or Ep |
| 46040-CPT | Moderate | Ncision & Drain Of Ischiorectal &/Or Perirectal Absces (Separ, Incision And Drainage Of Ischiorectal And/Or Perirectal Abscess (Separ |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45910. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45910 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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