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CPT code 45381: Colonoscopy injection, directed submucosal injection2026 Medicare rate & RVUs in Kansas

Colonoscopy with directed submucosal injection is reported when an endoscopist injects beneath a colonic lesion to lift it or mark its location.

CMS RVU26DEffective Oct 1, 2026One payment locality81.9K Medicare services in 2024

In Kansas, Medicare pays $448.77 for 45381 in the office and $166.15 when it’s performed in a hospital or facility.

$448.77Office (non-facility)
$166.15Hospital or facility
−8.5%vs the national office rate ($490.33)

Check a contract rate as a % of Medicare · 45381 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 45381 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kansas
  2. What 45381 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 45381 covers

During colonoscopy, the endoscopist directs material into the tissue layer beneath the colonic lining. Common reasons include raising a flat lesion to facilitate endoscopic treatment or tattooing a lesion site for later localization. Gastroenterologists and colorectal surgeons typically perform the service in an endoscopy unit, ambulatory surgery center, hospital, or appropriately equipped office.

Report the service when the procedure record identifies the injection site, purpose, and substance or marking method. Injections during an endoscopic mucosal resection are included in the resection service; do not separately report this code for that same injection. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies occur together, endoscopy-family pricing applies. Modifier 50 is inappropriate for this colon procedure. Medicare does not pay an assistant-at-surgery service for this code; 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 Kansas compares for 45381

Across 109 of 109 payment localities, the office rate for 45381 runs from $432.71 in Arkansas to $655.86 in San Benito County, CA. Kansas pays $448.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

45381 in Kansas vs other payment areas
  1. Kansas · this page$448.77
  2. Los Angeles, CA · California$556.32+$107.55
  3. Washington, DC area · District of Columbia$562.32+$113.55
  4. Miami, FL · Florida$526.55+$77.78
  5. Chicago, IL · Illinois$511.11+$62.34
  6. Manhattan, NY · New York$564.35+$115.58
  7. Alaska · Alaska$565.40+$116.63

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

Every other payment area

45381 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$439.19$165.63
ArkansasArkansas$432.71$164.15
ArizonaArizona$477.13$174.19
Bakersfield, CACalifornia$521.64$179.00
Chico, CACalifornia$520.38$177.74
El Centro, CACalifornia$520.45$177.81
Fresno, CACalifornia$520.38$177.74
Hanford, CACalifornia$520.38$177.74

45381 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.

$432.71

$588.12

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

View every state and territory as a table
45381 office rate range by state
State / territoryOffice rate rangeLocalities
AK$565.401
AL$439.191
AR$432.711
AZ$477.131
CA$520.38–$655.8629
CO$511.711
CT$523.341
DC$562.321
DE$485.161
FL$481.52–$526.553
GA$454.10–$499.262
GU$533.791
HI$533.791
IA$451.231
ID$454.101
IL$466.87–$511.704
IN$456.811
KS$448.771
KY$449.131
LA$448.29–$470.972
MA$508.43–$563.452
MD$494.66–$562.323
ME$456.19–$481.912
MI$460.78–$487.332
MN$490.901
MO$440.23–$473.053
MS$436.571
MT$490.301
NC$461.111
ND$481.991
NE$453.851
NH$503.351
NJ$529.48–$556.242
NM$463.231
NV$488.341
NY$468.14–$577.885
OH$459.081
OK$448.631
OR$484.72–$528.592
PA$460.00–$509.902
PR$494.081
RI$502.911
SC$460.831
SD$481.011
TN$451.031
TX$456.89–$509.868
UT$467.271
VA$480.07–$562.322
VI$494.081
VT$479.791
WA$507.58–$575.362
WI$465.481
WV$449.161
WY$486.681

See 45381 in every payment locality

How the 45381 rate is calculated

Each of 45381’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 · 45381

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.47

3.47 RVUs× 1.000 GPCI

Practice expense10.79

10.79 RVUs× 1.000 GPCI

Malpractice0.42

0.42 RVUs× 1.000 GPCI

Adjusted RVUs

14.6800

Conversion factor

$33.4009

Medicare rate

$490.33

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

The exact Kansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,517

Code
45381
Physician work
3.47
Practice expense
10.79
Malpractice
0.42

GPCI2026.csv

54

Locality
Kansas
Physician work
1.000
Practice expense
0.904
Malpractice
0.504
Office calculation for 45381 in Kansas
ComponentRVULocality factorAdjusted
Physician work3.47× 1.0003.4700
Practice expense10.79× 0.9049.7542
Malpractice0.42× 0.5040.2117
Total RVUs13.4358
Conversion factor× 33.4009

Office rate, Kansas$448.77

Office: (3.47 × 1 + 10.79 × 0.904 + 0.42 × 0.504) × $33.4009 = $448.77

Facility: (3.47 × 1 + 1.43 × 0.904 + 0.42 × 0.504) × $33.4009 = $166.15

Open 45381 in the RVU calculator

Payment rules and modifiers for 45381

The CMS indicators that decide how 45381 is paid alongside other services.

CMS payment indicators · 45381

Colonoscopy injection, directed submucosal injection

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
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

45381 without 51 · national office

$490.33

Colonoscopy injection, directed submucosal injection

45381-51 · Second procedure: 50%

$245.17

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 45381

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

Codes related to 45381
CodeHow it relatesOffice range, Kansas
Used instead
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy when no directed submucosal injection is performed.$346.52
45380Colonoscopy with biopsy, single or multiple forceps biopsiesColonoscopy with biopsy when tissue sampling, rather than injection, is performed.$439.41
45382Colonoscopy, control of bleedingUse when the endoscopic intervention is directed at controlling hemorrhage.$667.93
45390Colonoscopy, mucosal lesion resectionEndoscopic mucosal resection includes submucosal injection when performed as part of the resection.No office rate

How 45381 has changed in Kansas

45381 · Office / nonfacility

$448.77

Effective 2026-10-01

The base rate is $60.48 higher than on 2025-10-01, moving from $388.29 to $448.77 (15.6%).

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

    $388.29changed to$448.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.56 changed to 3.47
    • Practice expense RVU 9.04 changed to 10.79
    • Malpractice RVU 0.47 changed to 0.42
    • Practice expense GPCI 0.906 changed to 0.904
    • Malpractice GPCI 0.540 changed to 0.504

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $405.68changed to$388.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.26 changed to 9.04
    • Malpractice RVU 0.44 changed to 0.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $399.06changed to$405.68

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $414.37changed to$399.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.32 changed to 9.26
    • Malpractice RVU 0.43 changed to 0.44
    • Practice expense GPCI 0.907 changed to 0.906
    • Malpractice GPCI 0.499 changed to 0.540

  5. January 1, 2023

    RVU23A

    $431.35changed to$414.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.60 changed to 9.32
    • Malpractice RVU 0.41 changed to 0.43
    • Practice expense GPCI 0.908 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.499

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $427.48changed to$431.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.36 changed to 9.60
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $401.44changed to$427.48

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.07 changed to 9.36
    • Malpractice RVU 0.41 changed to 0.42
    • Practice expense GPCI 0.910 changed to 0.908
    • Malpractice GPCI 0.536 changed to 0.458

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $384.63changed to$401.44

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.49 changed to 8.07
    • Malpractice RVU 0.47 changed to 0.41
    • Practice expense GPCI 0.911 changed to 0.910
    • Malpractice GPCI 0.615 changed to 0.536

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $368.68changed to$384.63

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.01 changed to 7.49
    • Malpractice RVU 0.48 changed to 0.47

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $365.10changed to$368.68

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.96 changed to 7.01
    • Malpractice RVU 0.47 changed to 0.48
    • Practice expense GPCI 0.907 changed to 0.911
    • Malpractice GPCI 0.639 changed to 0.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $422.41changed to$365.10

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.66 changed to 3.56
    • Practice expense RVU 8.66 changed to 6.96
    • Malpractice RVU 0.48 changed to 0.47
    • Practice expense GPCI 0.903 changed to 0.907
    • Malpractice GPCI 0.662 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $438.85changed to$422.41

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 4.19 changed to 3.66
    • Practice expense RVU 8.43 changed to 8.66
    • Malpractice RVU 0.62 changed to 0.48

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $436.66changed to$438.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $437.70changed to$436.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.39 changed to 8.43
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 0.899 changed to 0.903
    • Malpractice GPCI 0.810 changed to 0.662

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $457.20changed to$437.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.67 changed to 8.39
    • Malpractice RVU 0.63 changed to 0.60
    • Practice expense GPCI 0.894 changed to 0.899
    • Malpractice GPCI 0.957 changed to 0.810

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $457.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$448.77$166.15RVU26D
2026-07-01$448.77$166.15RVU26C
2026-04-01$448.77$166.15RVU26B
2026-01-01$448.77$166.15RVU26A
2025-10-01$388.29$179.92RVU25D
2025-07-01$388.29$179.92RVU25C
2025-04-01$388.29$179.92RVU25B
2025-01-01$388.29$179.92RVU25A
2024-10-01$405.68$184.02RVU24D
2024-07-01$405.68$184.02RVU24C
2024-04-01$405.68$184.02RVU24B
2024-03-09$405.68$184.02RVU24AR
2024-01-01$399.06$181.01RVU24A
2023-10-01$414.37$186.00RVU23D
2023-07-01$414.37$186.00RVU23C
2023-04-01$414.37$186.00RVU23B
2023-01-01$414.37$186.00RVU23A
2022-10-01$431.35$189.08RVU22D
2022-07-01$431.35$189.08RVU22C
2022-04-01$431.35$189.08RVU22B
2022-01-01$431.35$189.08RVU22A
2021-10-01$427.48$190.18RVU21D
2021-07-01$427.48$190.18RVU21C
2021-04-01$427.48$190.18RVU21B
2021-01-01$427.48$190.18RVU21A
2020-10-01$401.44$196.18RVU20D
2020-07-01$401.44$196.18RVU20C
2020-04-01$401.44$196.18RVU20B
2020-01-01$401.44$196.18RVU20A
2019-10-01$384.63$199.13RVU19D
2019-07-01$384.63$199.13RVU19C
2019-04-01$384.63$199.13RVU19B
2019-01-01$384.63$199.13RVU19A
2018-10-01$368.68$200.11RVU18D
2018-07-01$368.68$200.11RVU18C
2018-04-01$368.68$200.11RVU18B
2018-01-01$368.68$200.11RVU18AR1
2017-10-01$365.10$199.41RVU17D
2017-07-01$365.10$199.41RVU17C
2017-04-01$365.10$199.41RVU17B
2017-01-01$365.10$199.41RVU17A
2016-10-01$422.41$204.17RVU16D
2016-07-01$422.41$204.17RVU16C
2016-04-01$422.41$204.17RVU16B
2016-01-01$422.41$204.17RVU16A
2015-10-01$438.85$236.70RVU15D
2015-07-01$438.85$236.70RVU15C
2015-04-01$436.66$235.52RVU15B
2015-01-01$436.66$235.52RVU15A
2014-10-01$437.70$239.00RVU14D
2014-07-01$437.70$239.00RVU14C
2014-04-01$437.70$239.00RVU14B
2014-01-01$437.70$239.00RVU14A
2013-10-01$457.20$239.72RVU13D
2013-07-01$457.20$239.72RVU13C
2013-04-01$457.20$239.72RVU13B
2013-01-01$457.20$239.72RVU13AR

Price 45381 for an earlier date of service

Where the Kansas rate applies

Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.

  • Abbyville
  • Abilene
  • Ada
  • Admire
  • Agenda
  • Agra
  • Albert
  • Alden

Browse all communities in Kansas

45381 billing questions

When should this code be chosen instead of a biopsy code?

Use it for directed injection beneath the colonic lining, such as lifting or marking a lesion. Use the biopsy code when tissue sampling is the intervention.

Can it be reported with endoscopic mucosal resection?

The mucosal resection code includes submucosal injection when performed as part of that resection. Do not separately report this code for the same injection.

How many units should be reported for several injections?

Multiple directed injections during one colonoscopy do not create separate units; the code covers injection or injections.

What documentation supports reporting it?

Record the colonic site, why material was injected, and the substance or marking method used. Document whether the injection lifted a lesion or marked its location.

Which modifiers or surgical-assistance services are appropriate?

Modifier 50 is inappropriate for this colon procedure. Medicare does not pay an assistant-at-surgery service for this code, and co-surgeon and team-surgery reporting are not permitted.

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 45381PPRRVU2026_Oct_nonQPP.csv, line 5,517 (RVU26D)
Geographic factors for KansasGPCI2026.csv, line 54 (RVU26D)

Open CMS sourceHow we calculate rates

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