CPT 45915 Fee Schedule
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.
| 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 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45915 |
National average reimbursement for CPT 45915 by major payers:
$408.65
$438.54
$491.79
$375.17
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 45915 | $272.54 | 1497992101 - MEREDITH SCHMITT | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 45915 | $360.00 | 1306486634 - FREDERICKSBURG ENDOSCOPY CENTER, LLC | 834398314 - (VA) FREDERICKSBURG ENDOSCOPY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $620.00 | 1316190077 - CERRITOS SURGERY CENTER, LLC, CERRITOS SURGERY CENTER, LLC | 651211028 - (CA) CERRITOS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $854.00 | 1770572307 - BETHESDA SURGERY CENTER, LLC | 522080005 - (MD) BETHESDA SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $1327.00 | 1851717383 - NYEEQASC,LLC, NORTH QUEENS SURGICAL CENTER | 275370037 - (NY) NYEEQASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $700.00 | 1861029712 - EAST ATLANTA EYE SURGERY CENTER, LLC | 834671737 - (GA) EAST ATLANTA EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $444.00 | 1578643607 - PAIN CENTER LLC | 331048492 - (AR) THE PAIN CENTER OF JONESBORO, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $580.00 | 1669869111 - LB SURGICAL CENTER LLC | 473797318 - (CA) LB SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $803.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $4618.00 | 1609876556 - PEAK ONE SURGERY CENTER, LLC, PEAK ONE SURGERY CENTER | 201620230 - (CO) PEAK ONE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $811.00 | 1467515015 - SURGERY CENTER OF SILVERDALE LLC | 202974934 - (WA) SURGERY CENTER OF SILVERDALE L | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $773.00 | 1831280536 - EFFINGHAM SURGICAL PARTNERS LLC | 371409876 - (IL) EFFINGHAM SURGICAL PARTNERS, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $1558.00 | 1477516961 - CENTRUM SURGERY CENTER LTD | 752546712 - (CO) CENTRUM SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $2137.00 | 1528438884 - MCLEAN AMBULATORY SURGERY, LLC | 474966649 - (VA) MCLEAN AMBULATORY SURGERY LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45915 | $580.00 | 1407206972 - HEART OF TEXAS SURGERY CENTER PLLC, WACO CENTER OF SURGICAL ARTS | 811843636 - (TX) HEART OF TEXAS SURGERY CENTER PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 45915 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45915 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 45915 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). |
| 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). |
| 45905-CPT | Moderate | Dilation Of Anal Sphincter (Sepa Proc) Under Anesthe Other, Dilation Of Anal Sphincter (Separate Procedure) Under Anesthesia Other |
| 45915-CPT | Moderate | Remval Of Fecal Impaction Or Foreign Body (Sepa Proc) Under, Removal Of Fecal Impaction Or Foreign Body (Separate Procedure) Under |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45915. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45915 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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