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CPT code 45384: Colonoscopy polyp removal, hot biopsy or bipolar cautery2026 Medicare rate & RVUs in Alabama

Reports colonoscopic removal of a polyp or other lesion using hot biopsy forceps or bipolar cautery during a flexible colonoscopy.

CMS RVU26DEffective Oct 1, 2026One payment locality46.4K Medicare services in 2024

In Alabama, Medicare pays $482.28 for 45384 in the office and $188.26 when it’s performed in a hospital or facility.

$482.28Office (non-facility)
$188.26Hospital or facility
−10.6%vs the national office rate ($539.42)

Check a contract rate as a % of Medicare · 45384 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 45384 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 45384 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 45384 covers

During flexible colonoscopy, the endoscopist removes a polyp or other lesion using hot biopsy forceps or bipolar cautery. Gastroenterologists and colorectal surgeons commonly perform this in an endoscopy center or hospital outpatient department; it may also be performed in an appropriately equipped office. For example, a polyp treated with cautery during the examination is reported by the removal method, not as a diagnostic-only examination.

Select this code when the documented removal technique is hot biopsy forceps or bipolar cautery; a snare removal is reported with a different code. The procedure note should identify the lesion and document the technique used. The diagnostic examination is part of the therapeutic colonoscopy, rather than a separate diagnostic service for that same examination. This minor procedure 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. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 Alabama compares for 45384

Across 109 of 109 payment localities, the office rate for 45384 runs from $475.05 in Arkansas to $715.37 in San Benito County, CA. Alabama pays $482.28. The RVUs are the same everywhere; the geographic indexes change the dollars.

45384 in Alabama vs other payment areas
  1. Alabama · this page$482.28
  2. Los Angeles, CA · California$608.74+$126.46
  3. Washington, DC area · District of Columbia$617.68+$135.40
  4. Miami, FL · Florida$586.42+$104.14
  5. Chicago, IL · Illinois$568.67+$86.39
  6. Manhattan, NY · New York$622.46+$140.18
  7. Alaska · Alaska$621.70+$139.42

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

Every other payment area

45384 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$475.05$186.42
ArizonaArizona$524.51$198.91
Bakersfield, CACalifornia$571.08$202.81
Chico, CACalifornia$569.32$201.05
El Centro, CACalifornia$569.43$201.16
Fresno, CACalifornia$569.32$201.05
Hanford, CACalifornia$569.32$201.05
Madera, CACalifornia$569.32$201.05

45384 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.

$475.05

$642.35

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

View every state and territory as a table
45384 office rate range by state
State / territoryOffice rate rangeLocalities
AK$621.701
AL$482.281
AR$475.051
AZ$524.511
CA$569.32–$715.3729
CO$561.291
CT$576.111
DC$617.681
DE$533.391
FL$532.67–$586.423
GA$501.60–$550.102
GU$583.791
HI$583.791
IA$494.291
ID$497.771
IL$517.27–$568.674
IN$500.741
KS$492.221
KY$494.801
LA$494.13–$519.402
MA$557.89–$617.592
MD$543.72–$617.683
ME$500.81–$528.432
MI$508.43–$539.882
MN$536.291
MO$485.56–$520.923
MS$480.391
MT$539.381
NC$506.181
ND$527.321
NE$497.001
NH$552.721
NJ$582.26–$611.002
NM$511.441
NV$536.411
NY$514.05–$638.415
OH$505.971
OK$493.531
OR$531.83–$579.232
PA$506.62–$561.592
PR$543.371
RI$552.501
SC$507.001
SD$525.901
TN$494.821
TX$503.20–$559.788
UT$514.161
VA$526.86–$617.682
VI$543.371
VT$525.501
WA$556.76–$630.052
WI$509.091
WV$497.581
WY$534.131

See 45384 in every payment locality

How the 45384 rate is calculated

Each of 45384’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 · 45384

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.97

3.97 RVUs× 1.000 GPCI

Practice expense11.57

11.57 RVUs× 1.000 GPCI

Malpractice0.61

0.61 RVUs× 1.000 GPCI

Adjusted RVUs

16.1500

Conversion factor

$33.4009

Medicare rate

$539.42

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

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,519

Code
45384
Physician work
3.97
Practice expense
11.57
Malpractice
0.61

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 45384 in Alabama
ComponentRVULocality factorAdjusted
Physician work3.97× 1.0003.9700
Practice expense11.57× 0.87510.1238
Malpractice0.61× 0.5660.3453
Total RVUs14.4390
Conversion factor× 33.4009

Office rate, Alabama$482.28

Office: (3.97 × 1 + 11.57 × 0.875 + 0.61 × 0.566) × $33.4009 = $482.28

Facility: (3.97 × 1 + 1.51 × 0.875 + 0.61 × 0.566) × $33.4009 = $188.26

Open 45384 in the RVU calculator

Payment rules and modifiers for 45384

The CMS indicators that decide how 45384 is paid alongside other services.

CMS payment indicators · 45384

Colonoscopy polyp removal, hot biopsy or bipolar cautery

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

45384 without 51 · national office

$539.42

Colonoscopy polyp removal, hot biopsy or bipolar cautery

45384-51 · Second procedure: 50%

$269.71

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 45384

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

Codes related to 45384
CodeHow it relatesOffice range, Alabama
Used instead
45385Snare polypectomy, during colonoscopyColonoscopy lesion removal by snare rather than hot biopsy forceps or bipolar cautery.$450.87
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy when no therapeutic lesion removal is performed.$339.88
45390Colonoscopy, mucosal lesion resectionColonoscopy lesion resection using a different, more extensive endoscopic technique.No office rate
Same family
45380Colonoscopy with biopsy, single or multiple forceps biopsiesColonoscopy service for tissue sampling by biopsy rather than cautery removal.$430.13

How 45384 has changed in Alabama

45384 · Office / nonfacility

$482.28

Effective 2026-10-01

The base rate is $65.13 higher than on 2025-10-01, moving from $417.15 to $482.28 (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

    $417.15changed to$482.28

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.07 changed to 3.97
    • Practice expense RVU 9.74 changed to 11.57
    • Malpractice RVU 0.63 changed to 0.61
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $434.59changed to$417.15

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.93 changed to 9.74
    • Malpractice RVU 0.62 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $427.50changed to$434.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $451.30changed to$427.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.03 changed to 9.93
    • Malpractice RVU 0.59 changed to 0.62
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575

  5. January 1, 2023

    RVU23A

    $476.49changed to$451.30

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.30 changed to 10.03
    • Malpractice RVU 0.60 changed to 0.59
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $476.99changed to$476.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.23 changed to 10.30
    • Malpractice RVU 0.56 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $446.72changed to$476.99

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.90 changed to 10.23
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $428.38changed to$446.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.44 changed to 8.90
    • Malpractice RVU 0.62 changed to 0.56
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $418.30changed to$428.38

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.14 changed to 8.44

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$418.30

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$482.28$188.26RVU26D
2026-07-01$482.28$188.26RVU26C
2026-04-01$482.28$188.26RVU26B
2026-01-01$482.28$188.26RVU26A
2025-10-01$417.15$201.55RVU25D
2025-07-01$417.15$201.55RVU25C
2025-04-01$417.15$201.55RVU25B
2025-01-01$417.15$201.55RVU25A
2024-10-01$434.59$206.65RVU24D
2024-07-01$434.59$206.65RVU24C
2024-04-01$434.59$206.65RVU24B
2024-03-09$434.59$206.65RVU24AR
2024-01-01$427.50$203.27RVU24A
2023-10-01$451.30$213.27RVU23D
2023-07-01$451.30$213.27RVU23C
2023-04-01$451.30$213.27RVU23B
2023-01-01$451.30$213.27RVU23A
2022-10-01$476.49$222.35RVU22D
2022-07-01$476.49$222.35RVU22C
2022-04-01$476.49$222.35RVU22B
2022-01-01$476.49$222.35RVU22A
2021-10-01$476.99$222.29RVU21D
2021-07-01$476.99$222.29RVU21C
2021-04-01$476.99$222.29RVU21B
2021-01-01$476.99$222.29RVU21A
2020-10-01$446.72$224.38RVU20D
2020-07-01$446.72$224.38RVU20C
2020-04-01$446.72$224.38RVU20B
2020-01-01$446.72$224.38RVU20A
2019-10-01$428.38$221.50RVU19D
2019-07-01$428.38$221.50RVU19C
2019-04-01$428.38$221.50RVU19B
2019-01-01$428.38$221.50RVU19A
2018-10-01$418.30$222.22RVU18D
2018-07-01$418.30$222.22RVU18C
2018-04-01$418.30$222.22RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 45384 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

45384 billing questions

When should 45384 be chosen over 45385?

Use 45384 when the lesion is removed with hot biopsy forceps or bipolar cautery. Use 45385 when the documented removal method is a snare.

Can the diagnostic colonoscopy also be reported?

The diagnostic inspection is included when the colonoscopy proceeds to lesion removal during the same examination. Do not separately report 45378 for that same examination.

How does 45384 differ from a colonoscopy biopsy?

45384 represents lesion removal by cautery technique. Use 45380 when the service is tissue sampling by biopsy rather than removal using the 45384 technique.

What documentation supports reporting 45384?

The procedure note should identify the lesion and state that hot biopsy forceps or bipolar cautery was used to remove it. The documented technique distinguishes this code from snare removal.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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 45384PPRRVU2026_Oct_nonQPP.csv, line 5,519 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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