CARC 45: Charge exceeds fee schedule/maximum allowable
The provider billed more than the contracted or allowed rate. You're only responsible for your share of the allowed amount — not the billed amount.
What this means for your claim
This is one of the most common codes on an EOB. The 'write-off' is the difference between the billed charge and what the insurer and plan agreed is the maximum allowable. In-network providers cannot bill you for this difference (balance billing protection).
What to do next
- 1
Verify your patient responsibility is calculated against the allowed amount, not the billed charge.
- 2
If an in-network provider bills you for the difference between what they charged and what was allowed, that is a contract violation — contact your insurer.
- 3
Review your EOB to confirm the allowed amount, insurer payment, and your share all add up correctly.
Have more codes on your EOB?
Upload your full Explanation of Benefits and our analyzer will identify every adjustment code, explain each one in plain English, and flag anything worth disputing.
Analyze My EOB Free →