CPT 48105 Fee Schedule
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.
| 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 • AS - PA/NP/CNS assistant at surgery • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| CMS | $2,741.69 Physician Fee Schedule |
National average reimbursement for CPT 48105 by major payers:
$3,442.61
$3,785.59
$3,951.52
$4,634.33
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 48105 | ||||||
United | 48105 | $1064.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $524.00 | 1326091513 - PAIN TREATMENT CENTERS OF MICHIGAN LLC, MATRIX SURGERY CENTER | 770623438 - (MI) PAIN TREATMENT CENTERS OF MICHIGAN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $556.00 | 1134427297 - SURGERY CENTER OF ZACHARY, LLC | 811928790 - (LA) SURGERY CENTER OF ZACHARY, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $4300.00 | 1861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS | 270907140 - (NJ) CENTER FOR AMBULATORY AND MINI | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $750.00 | 1477949766 - DESCHUTES SURGERY CENTER, LLC, DESCHUTES SURGERY CENTER, LLC | 472920584 - (OR) DESCHUTES SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $1299.00 | 1083785398 - OLYMPIA ORTHOPAEDIC ASSOCIATES PLLC, OLYMPIA SURGERY CENTER LLC | 911674528 - OLYMPIA ORTHOPAEDIC ASSOCIATES, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $1192.00 | 1366864514 - GREAT SOUTH BAY ENDOSCOPY CENTER, LLC | 463055867 - (NY) GREAT SOUTH BAY ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $495.00 | 1821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC | 273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $882.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364091497 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $1124.00 | 1881225639 - BANNER SURGERY CENTER | 843441285 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $750.00 | 1053328781 - LOS ALAMITOS SURGERY CENTER L P | 550823348 - (CA) LOS ALAMITOS SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $1313.00 | 1548984263 - ALLINA HEALTH SURGERY CENTER | 883732480 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $603.00 | 1124396544 - VALLEY PLASTIC SURGERY LLC, VALLEY PLASTIC SURGERY | 454030103 - (OR) VALLEY PLASTIC SURGERY LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $430.00 | 1164528527 - CENTER FOR DIGESTIVE CARE LLC | 30447062 - (MI) CENTER FOR DIGESTIVE CARE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 48105 | $369.00 | 1710931134 - NOVAMED SURGERY CENTER OF JONESBORO, LLC, EYE SURGERY CENTER OF ARKANSAS | 204407053 - (AR) NOVAMED SURGERY CENTER OF JONESBORO LLC | AR | 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 48105 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 48105 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 48105 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 48105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 48105 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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