Summary & Overview
CPT 45108: Excision of Anorectal Muscle Tumor
CPT code 45108 denotes surgical excision of a tumor of the anorectal muscle with submission of the specimen for laboratory analysis. This code identifies a procedure used to remove anorectal neoplasms for diagnostic and therapeutic purposes and is relevant across surgical specialties that manage anorectal tumors. Nationally, accurate coding for this procedure supports clinical documentation, appropriate payment, and tracking of oncologic surgical care patterns.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents clinically and operationally, typical sites of service, and the types of benchmarks and policy considerations commonly associated with surgical excision codes. The publication reviews reimbursement benchmarking, documentation expectations, and potential policy updates that affect coverage and coding practice for anorectal tumor excision procedures.
This summary prepares providers, billing professionals, and policy analysts to understand the coding context for CPT code 45108, the clinical scenario it captures, and the kinds of metrics and policy topics examined in the full publication. Data not available in the input for some supplemental fields is noted where applicable.
Billing Code Overview
CPT code 45108 describes the excision of a tumor of the anorectal muscle with submission of the specimen to the laboratory for diagnostic analysis. This procedure is a surgical tumor excision focused on anorectal musculature and surrounding tissue.
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Service type: Surgical excision of anorectal tumor
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Typical site of service: Ambulatory surgery center or hospital operating room
Data not available in the input for payers, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old adult who presents to colorectal surgery clinic with a solitary, palpable anorectal mass causing bleeding, pain, or altered bowel habits. After outpatient evaluation including history, physical examination with anoscopy or proctoscopy, and imaging as indicated (endorectal ultrasound or pelvic MRI), the surgeon elects excisional biopsy of the lesion under local, regional, or general anesthesia. In the operating room or procedure suite, the provider performs a full-thickness excision of the tumor involving the anorectal sphincter complex or anorectal muscular tissue, achieves hemostasis, and sends the specimen fresh or in formalin to the pathology laboratory for diagnostic histopathology and possible immunohistochemistry. Postoperative workflow includes specimen labeling and requisition, pathology processing and reporting, immediate postoperative recovery, and outpatient follow-up to review pathology results and plan further oncologic management if malignancy is identified.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified — not typically used for claims | Rarely used; avoid when a specific modifier applies |
11 | Professional component |