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CPT code 45378: Colonoscopy, diagnostic, no tissue removal2026 Medicare rate & RVUs in King County, WA

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 King County, WA, Medicare pays $439.51 for 45378 in the office and $177.63 when it’s performed in a hospital or facility.

$439.51Office (non-facility)
$177.63Hospital or facility
+16.2%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 King County, WA
  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 King County, WA 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. King County, WA pays $439.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

45378 in King County, WA vs other payment areas
  1. King County, WA · this page$439.51
  2. Rest of Washington · Washington$389.89−$49.62
  3. Los Angeles, CA · California$425.10−$14.41
  4. Washington, DC area · District of Columbia$431.34−$8.17
  5. Miami, FL · Florida$409.62−$29.89
  6. Chicago, IL · Illinois$397.87−$41.64
  7. Manhattan, NY · New York$434.75−$4.76

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

Every other payment area

45378 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$441.84$214.53
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

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 45378 in King County, WA
ComponentRVULocality factorAdjusted
Physician work3.18× 1.0503.3390
Practice expense7.73× 1.2279.4847
Malpractice0.41× 0.8170.3350
Total RVUs13.1587
Conversion factor× 33.4009

Office rate, King County, WA$439.51

Office: (3.18 × 1.05 + 7.73 × 1.227 + 0.41 × 0.817) × $33.4009 = $439.51

Facility: (3.18 × 1.05 + 1.34 × 1.227 + 0.41 × 0.817) × $33.4009 = $177.63

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, King County, WA
Same family
45380Colonoscopy with biopsy, single or multiple forceps biopsiesColonoscopy with tissue biopsy rather than diagnostic inspection alone.$562.66
45384Colonoscopy polyp removal, hot biopsy or bipolar cauteryColonoscopy with lesion removal using hot biopsy forceps or bipolar cautery.$630.05
45385Snare polypectomy, during colonoscopyColonoscopy with lesion removal by snare technique.$580.16
45379Colonoscopy, foreign body removalColonoscopy that includes removal of a foreign body.$556.74
Used instead
45330Flexible sigmoidoscopy, diagnosticDiagnostic flexible sigmoidoscopy examines a more limited portion of the bowel.$257.44

How 45378 has changed in King County, WA

45378 · Office / nonfacility

$439.51

Effective 2026-10-01

The base rate is $63.52 higher than on 2025-10-01, moving from $375.99 to $439.51 (16.9%).

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

    $375.99changed to$439.51

    • 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 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $389.49changed to$375.99

    • 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

    $383.13changed to$389.49

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $392.65changed to$383.13

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $402.81changed to$392.65

    • 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 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $402.25changed to$402.81

    • 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

    $376.73changed to$402.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.75 changed to 6.56
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $361.60changed to$376.73

    • 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 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $354.52changed to$361.60

    • 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

    $349.35changed to$354.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.26 changed to 5.29
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $418.40changed to$349.35

    • 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 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $428.51changed to$418.40

    • 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

    $426.37changed to$428.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $428.60changed to$426.37

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.78 changed to 6.81
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $449.57changed to$428.60

    • 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 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $449.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$439.51$177.63RVU26D
2026-07-01$439.51$177.63RVU26C
2026-04-01$439.51$177.63RVU26B
2026-01-01$439.51$177.63RVU26A
2025-10-01$375.99$192.49RVU25D
2025-07-01$375.99$192.49RVU25C
2025-04-01$375.99$192.49RVU25B
2025-01-01$375.99$192.49RVU25A
2024-10-01$389.49$196.99RVU24D
2024-07-01$389.49$196.99RVU24C
2024-04-01$389.49$196.99RVU24B
2024-03-09$389.49$196.99RVU24AR
2024-01-01$383.13$193.77RVU24A
2023-10-01$392.65$197.55RVU23D
2023-07-01$392.65$197.55RVU23C
2023-04-01$392.65$197.55RVU23B
2023-01-01$392.65$197.55RVU23A
2022-10-01$402.81$199.52RVU22D
2022-07-01$402.81$199.52RVU22C
2022-04-01$402.81$199.52RVU22B
2022-01-01$402.81$199.52RVU22A
2021-10-01$402.25$201.02RVU21D
2021-07-01$402.25$201.02RVU21C
2021-04-01$402.25$201.02RVU21B
2021-01-01$402.25$201.02RVU21A
2020-10-01$376.73$204.87RVU20D
2020-07-01$376.73$204.87RVU20C
2020-04-01$376.73$204.87RVU20B
2020-01-01$376.73$204.87RVU20A
2019-10-01$361.60$205.89RVU19D
2019-07-01$361.60$205.89RVU19C
2019-04-01$361.60$205.89RVU19B
2019-01-01$361.60$205.89RVU19A
2018-10-01$354.52$206.83RVU18D
2018-07-01$354.52$206.83RVU18C
2018-04-01$354.52$206.83RVU18B
2018-01-01$354.52$206.83RVU18AR1
2017-10-01$349.35$202.70RVU17D
2017-07-01$349.35$202.70RVU17C
2017-04-01$349.35$202.70RVU17B
2017-01-01$349.35$202.70RVU17A
2016-10-01$418.40$203.77RVU16D
2016-07-01$418.40$203.77RVU16C
2016-04-01$418.40$203.77RVU16B
2016-01-01$418.40$203.77RVU16A
2015-10-01$428.51$226.39RVU15D
2015-07-01$428.51$226.39RVU15C
2015-04-01$426.37$225.26RVU15B
2015-01-01$426.37$225.26RVU15A
2014-10-01$428.60$229.21RVU14D
2014-07-01$428.60$229.21RVU14C
2014-04-01$428.60$229.21RVU14B
2014-01-01$428.60$229.21RVU14A
2013-10-01$449.57$232.00RVU13D
2013-07-01$449.57$232.00RVU13C
2013-04-01$449.57$232.00RVU13B
2013-01-01$449.57$232.00RVU13AR

Price 45378 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 45378 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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