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CPT code 45382: Colonoscopy, control of bleeding2026 Medicare rate & RVUs in Virginia

Reports colonoscopy with endoscopic treatment of active colonic bleeding, such as bleeding from angiodysplasia, a diverticulum, or a prior procedure site.

CMS RVU26DEffective Oct 1, 2026One payment locality22.4K Medicare services in 2024

In Virginia, Medicare pays $715.68 for 45382 in the office and $220.89 when it’s performed in a hospital or facility.

$715.68Office (non-facility)
$220.89Hospital or facility
−2.0%vs the national office rate ($730.14)

Check a contract rate as a % of Medicare · 45382 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 45382 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 45382 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 45382 covers

A gastroenterologist or other qualified endoscopist uses a colonoscope to locate and treat a bleeding source in the colon. Hemostasis may involve a clip, thermal treatment, or injection, depending on the source and clinical circumstances. Examples include active bleeding from angiodysplasia or a diverticulum, and bleeding at a prior polypectomy site. The service is commonly performed in a hospital outpatient department or ambulatory surgery center.

Select this code when the colonoscopy includes treatment to control bleeding, not merely inspection or routine hemostasis integral to another intervention. The procedure report should identify the bleeding site, findings, treatment method, and response. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, 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 Virginia compares for 45382

Across 109 of 109 payment localities, the office rate for 45382 runs from $642.83 in Arkansas to $987.39 in San Benito County, CA. Virginia pays $715.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

45382 in Virginia vs other payment areas
  1. Virginia · this page$715.68
  2. Los Angeles, CA · California$833.56+$117.88
  3. Washington, DC area · District of Columbia$840.22+$124.54
  4. Miami, FL · Florida$778.71+$63.03
  5. Chicago, IL · Illinois$755.64+$39.96
  6. Manhattan, NY · New York$840.65+$124.97
  7. Alaska · Alaska$834.98+$119.30

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

Every other payment area

45382 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$652.67$212.24
ArkansasArkansas$642.83$210.45
ArizonaArizona$710.32$222.58
Bakersfield, CACalifornia$780.43$228.75
Chico, CACalifornia$778.91$227.23
El Centro, CACalifornia$778.99$227.32
Fresno, CACalifornia$778.91$227.23
Hanford, CACalifornia$778.91$227.23

45382 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.

$642.83

$883.15

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

View every state and territory as a table
45382 office rate range by state
State / territoryOffice rate rangeLocalities
AK$834.981
AL$652.671
AR$642.831
AZ$710.321
CA$778.91–$987.3929
CO$764.261
CT$779.941
DC$840.221
DE$722.471
FL$713.82–$778.713
GA$672.68–$742.942
GU$800.081
HI$800.081
IA$672.321
ID$676.401
IL$690.67–$759.274
IN$680.551
KS$667.931
KY$666.361
LA$664.83–$699.272
MA$758.96–$843.512
MD$737.03–$840.223
ME$678.89–$718.922
MI$683.42–$721.942
MN$734.681
MO$652.18–$703.213
MS$647.691
MT$730.111
NC$686.471
ND$720.221
NE$676.501
NH$751.091
NJ$789.52–$830.722
NM$686.871
NV$727.921
NY$697.09–$860.345
OH$681.401
OK$666.311
OR$722.94–$790.652
PA$683.16–$759.132
PR$736.071
RI$749.761
SC$684.941
SD$719.051
TN$671.291
TX$678.40–$761.138
UT$694.731
VA$715.68–$840.222
VI$736.071
VT$716.281
WA$757.90–$862.202
WI$694.991
WV$663.751
WY$725.801

See 45382 in every payment locality

How the 45382 rate is calculated

Each of 45382’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 · 45382

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.54

4.54 RVUs× 1.000 GPCI

Practice expense16.82

16.82 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

21.8600

Conversion factor

$33.4009

Medicare rate

$730.14

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,518

Code
45382
Physician work
4.54
Practice expense
16.82
Malpractice
0.50

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 45382 in Virginia
ComponentRVULocality factorAdjusted
Physician work4.54× 1.0004.5400
Practice expense16.82× 0.98316.5341
Malpractice0.50× 0.7060.3530
Total RVUs21.4271
Conversion factor× 33.4009

Office rate, Virginia$715.68

Office: (4.54 × 1 + 16.82 × 0.983 + 0.5 × 0.706) × $33.4009 = $715.68

Facility: (4.54 × 1 + 1.75 × 0.983 + 0.5 × 0.706) × $33.4009 = $220.89

Open 45382 in the RVU calculator

Payment rules and modifiers for 45382

The CMS indicators that decide how 45382 is paid alongside other services.

CMS payment indicators · 45382

Colonoscopy, control of bleeding

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

45382 without 51 · national office

$730.14

Colonoscopy, control of bleeding

45382-51 · Second procedure: 50%

$365.07

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 45382

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

Codes related to 45382
CodeHow it relatesOffice range, Virginia
Used instead
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy without endoscopic treatment of bleeding.$369.68
Same family
45380Colonoscopy with biopsy, single or multiple forceps biopsiesColonoscopy with biopsy; selected when tissue sampling is performed.$469.90
45381Colonoscopy injection, directed submucosal injectionColonoscopy with submucosal injection for a purpose other than bleeding control.$480.07
45384Colonoscopy polyp removal, hot biopsy or bipolar cauteryColonoscopy with lesion removal by a method distinct from bleeding control.$526.86
45385Snare polypectomy, during colonoscopyColonoscopy with snare removal of a lesion.$489.33
45398Colonoscopy, with band ligationColonoscopy with band ligation, including when that specific intervention is performed.$883.93

How 45382 has changed in Virginia

45382 · Office / nonfacility

$715.68

Effective 2026-10-01

The base rate is $100.27 higher than on 2025-10-01, moving from $615.41 to $715.68 (16.3%).

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

    $615.41changed to$715.68

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.66 changed to 4.54
    • Practice expense RVU 14.16 changed to 16.82
    • Malpractice RVU 0.56 changed to 0.50
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $649.11changed to$615.41

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.65 changed to 14.16
    • Malpractice RVU 0.55 changed to 0.56

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $638.52changed to$649.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $670.83changed to$638.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.83 changed to 14.65
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $707.95changed to$670.83

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 15.39 changed to 14.83
    • Malpractice RVU 0.54 changed to 0.55
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $736.49changed to$707.95

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 16.07 changed to 15.39
    • Malpractice RVU 0.51 changed to 0.54

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $715.91changed to$736.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 14.85 changed to 16.07
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $719.53changed to$715.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.97 changed to 14.85
    • Malpractice RVU 0.60 changed to 0.51
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $730.81changed to$719.53

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 15.31 changed to 14.97

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $722.86changed to$730.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 15.19 changed to 15.31
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $791.97changed to$722.86

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.76 changed to 4.66
    • Practice expense RVU 17.14 changed to 15.19
    • Malpractice RVU 0.62 changed to 0.60
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $603.51changed to$791.97

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 5.68 changed to 4.76
    • Practice expense RVU 10.62 changed to 17.14
    • Malpractice RVU 0.82 changed to 0.62

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $600.51changed to$603.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $597.19changed to$600.51

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.58 changed to 10.62
    • Malpractice RVU 0.80 changed to 0.82
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $620.01changed to$597.19

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 12.21 changed to 10.58
    • Malpractice RVU 0.84 changed to 0.80
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $620.01

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$715.68$220.89RVU26D
2026-07-01$715.68$220.89RVU26C
2026-04-01$715.68$220.89RVU26B
2026-01-01$715.68$220.89RVU26A
2025-10-01$615.41$242.06RVU25D
2025-07-01$615.41$242.06RVU25C
2025-04-01$615.41$242.06RVU25B
2025-01-01$615.41$242.06RVU25A
2024-10-01$649.11$248.19RVU24D
2024-07-01$649.11$248.19RVU24C
2024-04-01$649.11$248.19RVU24B
2024-03-09$649.11$248.19RVU24AR
2024-01-01$638.52$244.14RVU24A
2023-10-01$670.83$253.15RVU23D
2023-07-01$670.83$253.15RVU23C
2023-04-01$670.83$253.15RVU23B
2023-01-01$670.83$253.15RVU23A
2022-10-01$707.95$260.32RVU22D
2022-07-01$707.95$260.32RVU22C
2022-04-01$707.95$260.32RVU22B
2022-01-01$707.95$260.32RVU22A
2021-10-01$736.49$260.50RVU21D
2021-07-01$736.49$260.50RVU21C
2021-04-01$736.49$260.50RVU21B
2021-01-01$736.49$260.50RVU21A
2020-10-01$715.91$267.41RVU20D
2020-07-01$715.91$267.41RVU20C
2020-04-01$715.91$267.41RVU20B
2020-01-01$715.91$267.41RVU20A
2019-10-01$719.53$270.02RVU19D
2019-07-01$719.53$270.02RVU19C
2019-04-01$719.53$270.02RVU19B
2019-01-01$719.53$270.02RVU19A
2018-10-01$730.81$271.14RVU18D
2018-07-01$730.81$271.14RVU18C
2018-04-01$730.81$271.14RVU18B
2018-01-01$730.81$271.14RVU18AR1
2017-10-01$722.86$269.32RVU17D
2017-07-01$722.86$269.32RVU17C
2017-04-01$722.86$269.32RVU17B
2017-01-01$722.86$269.32RVU17A
2016-10-01$791.97$273.19RVU16D
2016-07-01$791.97$273.19RVU16C
2016-04-01$791.97$273.19RVU16B
2016-01-01$791.97$273.19RVU16A
2015-10-01$603.51$330.46RVU15D
2015-07-01$603.51$330.46RVU15C
2015-04-01$600.51$328.82RVU15B
2015-01-01$600.51$328.82RVU15A
2014-10-01$597.19$327.93RVU14D
2014-07-01$597.19$327.93RVU14C
2014-04-01$597.19$327.93RVU14B
2014-01-01$597.19$327.93RVU14A
2013-10-01$620.01$324.17RVU13D
2013-07-01$620.01$324.17RVU13C
2013-04-01$620.01$324.17RVU13B
2013-01-01$620.01$324.17RVU13AR

Price 45382 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

45382 billing questions

When should this code be selected instead of diagnostic colonoscopy?

Use it when the endoscopist performs treatment to control bleeding during the colonoscopy. A diagnostic examination without endoscopic bleeding treatment is reported with 45378.

Can diagnostic colonoscopy be reported separately on the same claim?

The examination is part of the therapeutic colonoscopy, so do not separately report 45378 for the same procedure.

Is this code appropriate for routine hemostasis during polyp removal?

Do not use it for hemostasis that is integral to another intervention, such as routine control of bleeding during lesion removal. Document a separately performed service to control a bleeding source.

How does CMS price this with another endoscopy performed in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together. The claim should identify the procedures actually performed; CMS applies the family pricing methodology.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this code. CMS statutorily restricts assistant-at-surgery payment, and co-surgeons and team surgery are not permitted.

What documentation supports reporting bleeding control?

Document the bleeding source or site, the endoscopic treatment used, and the result. Findings alone, without treatment to control bleeding, do not support this therapeutic service.

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 45382PPRRVU2026_Oct_nonQPP.csv, line 5,518 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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