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CPT code 45378: Colonoscopy, diagnostic, no tissue removal2026 Medicare rate & RVUs in Delaware

Reports a diagnostic examination of the colon when the endoscopist inspects the colon without performing a separately described biopsy or therapeutic intervention.

CMS RVU26DEffective Oct 1, 2026One payment locality303.1K Medicare services in 2024

In Delaware, Medicare pays $374.15 for 45378 in the office and $163.28 when it’s performed in a hospital or facility.

$374.15Office (non-facility)
$163.28Hospital or facility
−1.0%vs the national office rate ($378.10)

Check a contract rate as a % of Medicare · 45378 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 45378 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 45378 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 45378 covers

A gastroenterologist or colorectal surgeon advances a flexible endoscope through the colon to examine the bowel, commonly for evaluation of symptoms or an abnormal finding. The service can include specimen collection by brushing or washing, but it does not describe taking tissue for biopsy or treating a lesion. It is typically performed in an endoscopy unit or hospital outpatient department, with sedation commonly provided as part of the procedural setting.

Choose this code when the documented service is diagnostic inspection rather than a more specific colonoscopy procedure. The report should support the examination performed and whether a biopsy or treatment was done; when a more specific procedure is performed, report that service rather than separately reporting the diagnostic examination. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Modifier 53 is separately priced. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Delaware compares for 45378

Across 109 of 109 payment localities, the office rate for 45378 runs from $335.05 in Arkansas to $497.55 in San Benito County, CA. Delaware pays $374.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

45378 in Delaware vs other payment areas
  1. Delaware · this page$374.15
  2. Los Angeles, CA · California$425.10+$50.95
  3. Washington, DC area · District of Columbia$431.34+$57.19
  4. Miami, FL · Florida$409.62+$35.47
  5. Chicago, IL · Illinois$397.87+$23.72
  6. Manhattan, NY · New York$434.75+$60.60
  7. Alaska · Alaska$441.84+$67.69

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

45378 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$339.88$153.13
ArkansasArkansas$335.05$151.71
ArizonaArizona$368.12$161.31
Bakersfield, CACalifornia$399.55$165.63
Chico, CACalifornia$398.34$164.41
El Centro, CACalifornia$398.40$164.48
Fresno, CACalifornia$398.34$164.41
Hanford, CACalifornia$398.34$164.41

45378 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$335.05

$447.95

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
45378 office rate range by state
State / territoryOffice rate rangeLocalities
AK$441.841
AL$339.881
AR$335.051
AZ$368.121
CA$398.34–$497.5529
CO$392.901
CT$402.981
DC$431.341
DE$374.151
FL$373.63–$409.623
GA$352.84–$385.302
GU$407.701
HI$407.701
IA$347.891
ID$350.231
IL$363.35–$397.874
IN$352.211
KS$346.521
KY$348.281
LA$347.83–$364.732
MA$390.70–$431.042
MD$381.14–$431.343
ME$352.27–$370.722
MI$357.40–$378.462
MN$375.941
MO$342.11–$365.733
MS$338.641
MT$378.071
NC$355.861
ND$369.961
NE$349.701
NH$386.971
NJ$407.43–$427.032
NM$359.421
NV$376.071
NY$361.12–$445.435
OH$355.751
OK$347.421
OR$373.00–$404.952
PA$356.17–$393.242
PR$380.731
RI$387.161
SC$356.421
SD$369.011
TN$348.261
TX$353.89–$391.728
UT$361.211
VA$369.68–$431.342
VI$380.731
VT$368.751
WA$389.89–$439.512
WI$357.781
WV$350.181
WY$374.541

See 45378 in every payment locality

How the 45378 rate is calculated

Each of 45378’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 45378

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.18

3.18 RVUs× 1.000 GPCI

Practice expense7.73

7.73 RVUs× 1.000 GPCI

Malpractice0.41

0.41 RVUs× 1.000 GPCI

Adjusted RVUs

11.3200

Conversion factor

$33.4009

Medicare rate

$378.10

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,513

Code
45378
Physician work
3.18
Practice expense
7.73
Malpractice
0.41

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 45378 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.18× 1.0053.1959
Practice expense7.73× 0.9887.6372
Malpractice0.41× 0.8990.3686
Total RVUs11.2017
Conversion factor× 33.4009

Office rate, Delaware$374.15

Office: (3.18 × 1.005 + 7.73 × 0.988 + 0.41 × 0.899) × $33.4009 = $374.15

Facility: (3.18 × 1.005 + 1.34 × 0.988 + 0.41 × 0.899) × $33.4009 = $163.28

Open 45378 in the RVU calculator

Payment rules and modifiers for 45378

The CMS indicators that decide how 45378 is paid alongside other services.

CMS payment indicators · 45378

Colonoscopy, diagnostic, no tissue removal

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45378 without 51 · national office

$378.10

Colonoscopy, diagnostic, no tissue removal

45378-51 · Second procedure: 50%

$189.05

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 45378

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 45378
CodeHow it relatesOffice range, Delaware
Same family
45380Colonoscopy with biopsy, single or multiple forceps biopsiesColonoscopy with tissue biopsy rather than diagnostic inspection alone.$474.93
45384Colonoscopy polyp removal, hot biopsy or bipolar cauteryColonoscopy with lesion removal using hot biopsy forceps or bipolar cautery.$533.39
45385Snare polypectomy, during colonoscopyColonoscopy with lesion removal by snare technique.$495.03
45379Colonoscopy, foreign body removalColonoscopy that includes removal of a foreign body.$474.46
Used instead
45330Flexible sigmoidoscopy, diagnosticDiagnostic flexible sigmoidoscopy examines a more limited portion of the bowel.$212.63

How 45378 has changed in Delaware

45378 · Office / nonfacility

$374.15

Effective 2026-10-01

The base rate is $47.91 higher than on 2025-10-01, moving from $326.24 to $374.15 (14.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $326.24changed to$374.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.26 changed to 3.18
    • Practice expense RVU 6.44 changed to 7.73
    • Malpractice RVU 0.43 changed to 0.41
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $337.73changed to$326.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.51 changed to 6.44
    • Malpractice RVU 0.42 changed to 0.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $332.22changed to$337.73

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $346.75changed to$332.22

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $361.76changed to$346.75

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.66 changed to 6.51
    • Malpractice RVU 0.40 changed to 0.42
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $361.52changed to$361.76

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.56 changed to 6.66
    • Malpractice RVU 0.41 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $345.37changed to$361.52

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.75 changed to 6.56
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $337.37changed to$345.37

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.46 changed to 5.75
    • Malpractice RVU 0.46 changed to 0.41
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $331.17changed to$337.37

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.29 changed to 5.46
    • Malpractice RVU 0.47 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $330.23changed to$331.17

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.26 changed to 5.29
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $396.17changed to$330.23

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.36 changed to 3.26
    • Practice expense RVU 6.93 changed to 5.26
    • Malpractice RVU 0.48 changed to 0.47
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $408.27changed to$396.17

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 3.69 changed to 3.36
    • Practice expense RVU 6.81 changed to 6.93
    • Malpractice RVU 0.56 changed to 0.48

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $406.24changed to$408.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $403.49changed to$406.24

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.78 changed to 6.81
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $417.24changed to$403.49

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.79 changed to 6.78
    • Malpractice RVU 0.59 changed to 0.56
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $417.24

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$374.15$163.28RVU26D
2026-07-01$374.15$163.28RVU26C
2026-04-01$374.15$163.28RVU26B
2026-01-01$374.15$163.28RVU26A
2025-10-01$326.24$177.04RVU25D
2025-07-01$326.24$177.04RVU25C
2025-04-01$326.24$177.04RVU25B
2025-01-01$326.24$177.04RVU25A
2024-10-01$337.73$181.21RVU24D
2024-07-01$337.73$181.21RVU24C
2024-04-01$337.73$181.21RVU24B
2024-03-09$337.73$181.21RVU24AR
2024-01-01$332.22$178.25RVU24A
2023-10-01$346.75$183.97RVU23D
2023-07-01$346.75$183.97RVU23C
2023-04-01$346.75$183.97RVU23B
2023-01-01$346.75$183.97RVU23A
2022-10-01$361.76$187.75RVU22D
2022-07-01$361.76$187.75RVU22C
2022-04-01$361.76$187.75RVU22B
2022-01-01$361.76$187.75RVU22A
2021-10-01$361.52$189.28RVU21D
2021-07-01$361.52$189.28RVU21C
2021-04-01$361.52$189.28RVU21B
2021-01-01$361.52$189.28RVU21A
2020-10-01$345.37$195.40RVU20D
2020-07-01$345.37$195.40RVU20C
2020-04-01$345.37$195.40RVU20B
2020-01-01$345.37$195.40RVU20A
2019-10-01$337.37$198.92RVU19D
2019-07-01$337.37$198.92RVU19C
2019-04-01$337.37$198.92RVU19B
2019-01-01$337.37$198.92RVU19A
2018-10-01$331.17$199.84RVU18D
2018-07-01$331.17$199.84RVU18C
2018-04-01$331.17$199.84RVU18B
2018-01-01$331.17$199.84RVU18AR1
2017-10-01$330.23$199.64RVU17D
2017-07-01$330.23$199.64RVU17C
2017-04-01$330.23$199.64RVU17B
2017-01-01$330.23$199.64RVU17A
2016-10-01$396.17$204.59RVU16D
2016-07-01$396.17$204.59RVU16C
2016-04-01$396.17$204.59RVU16B
2016-01-01$396.17$204.59RVU16A
2015-10-01$408.27$227.85RVU15D
2015-07-01$408.27$227.85RVU15C
2015-04-01$406.24$226.72RVU15B
2015-01-01$406.24$226.72RVU15A
2014-10-01$403.49$223.52RVU14D
2014-07-01$403.49$223.52RVU14C
2014-04-01$403.49$223.52RVU14B
2014-01-01$403.49$223.52RVU14A
2013-10-01$417.24$218.68RVU13D
2013-07-01$417.24$218.68RVU13C
2013-04-01$417.24$218.68RVU13B
2013-01-01$417.24$218.68RVU13AR

Price 45378 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

45378 billing questions

When should 45378 be chosen instead of 45380?

Use 45378 for diagnostic inspection without tissue biopsy. When tissue is sampled for histologic examination, report the biopsy service, 45380, instead.

Can 45378 be reported with a colonoscopy that removes a polyp?

The diagnostic inspection is part of the colonoscopy with polyp removal; report the code for the removal method rather than separately billing 45378 for the same examination.

Is modifier 50 appropriate for 45378?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How should modifier 53 be handled?

CMS lists modifier 53 as separately priced for 45378. The record should support that the colonoscopy was discontinued; apply the modifier only when the circumstances meet its reporting requirements.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How many units are reported for the diagnostic examination?

Report one service for the colonoscopy, not a separate unit for each segment examined.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 45378PPRRVU2026_Oct_nonQPP.csv, line 5,513 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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