CPT code 45384: Colonoscopy polyp removal, hot biopsy or bipolar cautery2026 Medicare rate & RVUs in Montana
Reports colonoscopic removal of a polyp or other lesion using hot biopsy forceps or bipolar cautery during a flexible colonoscopy.
In Montana, Medicare pays $539.38 for 45384 in the office and $203.37 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Montana 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. Montana pays $539.38. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$539.38
- Los Angeles, CA · California$608.74+$69.36
- Washington, DC area · District of Columbia$617.68+$78.30
- Miami, FL · Florida$586.42+$47.04
- Chicago, IL · Illinois$568.67+$29.29
- Manhattan, NY · New York$622.46+$83.08
- Alaska · Alaska$621.70+$82.32
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $482.28 | $188.26 |
| 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 |
| Merced, CACalifornia | $569.32 | $201.05 |
| Modesto, CACalifornia | $569.32 | $201.05 |
| Napa, CACalifornia | $660.64 | $217.78 |
| Oxnard, CACalifornia | $605.79 | $208.62 |
| Redding, CACalifornia | $569.32 | $201.05 |
| Rest of CaliforniaCalifornia | $569.32 | $201.05 |
| Riverside, CACalifornia | $575.92 | $207.65 |
| Sacramento, CACalifornia | $597.74 | $206.95 |
| Salinas, CACalifornia | $595.53 | $206.09 |
| San Diego, CACalifornia | $609.81 | $207.94 |
| Marin County, CACalifornia | $699.44 | $225.66 |
| San Francisco, CACalifornia | $698.75 | $224.97 |
| San Benito County, CACalifornia | $715.37 | $230.84 |
| Santa Clara County, CACalifornia | $712.54 | $228.00 |
| San Luis Obispo, CACalifornia | $585.94 | $203.22 |
| Santa Cruz, CACalifornia | $615.84 | $207.59 |
| Santa Maria, CACalifornia | $597.83 | $206.04 |
| Santa Rosa, CACalifornia | $622.06 | $209.43 |
| Stockton, CACalifornia | $569.32 | $201.05 |
| Vallejo, CACalifornia | $659.65 | $216.78 |
| Visalia, CACalifornia | $569.32 | $201.05 |
| Yuba City, CACalifornia | $569.32 | $201.05 |
| ColoradoColorado | $561.29 | $203.77 |
| ConnecticutConnecticut | $576.11 | $214.23 |
| DelawareDelaware | $533.39 | $201.41 |
| Fort Lauderdale, FLFlorida | $560.91 | $220.53 |
| Rest of FloridaFlorida | $532.67 | $211.44 |
| Atlanta, GAGeorgia | $550.10 | $208.71 |
| Rest of GeorgiaGeorgia | $501.60 | $201.88 |
| Hawaii, Guam, HIHawaii | $583.79 | $201.74 |
| IowaIowa | $494.29 | $186.84 |
| IdahoIdaho | $497.77 | $188.64 |
| East St. Louis, ILIllinois | $529.17 | $220.04 |
| Rest of IllinoisIllinois | $517.27 | $210.49 |
| Suburban Chicago, ILIllinois | $566.52 | $221.43 |
| IndianaIndiana | $500.74 | $189.26 |
| KansasKansas | $492.22 | $188.46 |
| KentuckyKentucky | $494.80 | $196.08 |
| New Orleans, LALouisiana | $519.40 | $203.21 |
| Rest of LouisianaLouisiana | $494.13 | $196.76 |
| Metropolitan Boston, MAMassachusetts | $617.59 | $216.39 |
| Rest of MassachusettsMassachusetts | $557.89 | $204.07 |
| Baltimore area, MDMaryland | $574.59 | $214.04 |
| Rest of MarylandMaryland | $543.72 | $203.67 |
| Rest of MaineMaine | $500.81 | $191.68 |
| Southern Maine, MEMaine | $528.43 | $195.44 |
| Detroit, MIMichigan | $539.88 | $215.62 |
| Rest of MichiganMichigan | $508.43 | $201.65 |
| MinnesotaMinnesota | $536.29 | $190.53 |
| Metropolitan Kansas City, MOMissouri | $515.38 | $199.87 |
| Metropolitan St. Louis, MOMissouri | $520.92 | $201.03 |
| Rest of MissouriMissouri | $485.56 | $195.92 |
| MississippiMississippi | $480.39 | $191.08 |
| North CarolinaNorth Carolina | $506.18 | $192.68 |
| North DakotaNorth Dakota | $527.32 | $191.31 |
| NebraskaNebraska | $497.00 | $186.85 |
| New HampshireNew Hampshire | $552.72 | $202.93 |
| Northern New JerseyNew Jersey | $611.00 | $221.22 |
| Rest of New JerseyNew Jersey | $582.26 | $215.33 |
| New MexicoNew Mexico | $511.44 | $203.32 |
| NevadaNevada | $536.41 | $200.06 |
| NYC suburbs and Long Island, NYNew York | $638.41 | $238.89 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $586.38 | $218.45 |
| Queens, NYNew York | $627.25 | $230.08 |
| Rest of New YorkNew York | $514.05 | $194.84 |
| OhioOhio | $505.97 | $199.19 |
| OklahomaOklahoma | $493.53 | $193.47 |
| Portland, OROregon | $579.23 | $205.92 |
| Rest of OregonOregon | $531.83 | $197.16 |
| Metropolitan Philadelphia, PAPennsylvania | $561.59 | $211.80 |
| Rest of PennsylvaniaPennsylvania | $506.62 | $198.16 |
| Puerto RicoPuerto Rico | $543.37 | $203.66 |
| Rhode IslandRhode Island | $552.50 | $205.39 |
| South CarolinaSouth Carolina | $507.00 | $196.52 |
| South DakotaSouth Dakota | $525.90 | $189.88 |
| TennesseeTennessee | $494.82 | $189.39 |
| Austin, TXTexas | $559.78 | $204.28 |
| Beaumont, TXTexas | $503.20 | $197.43 |
| Brazoria, TXTexas | $532.52 | $199.54 |
| Dallas, TXTexas | $536.18 | $201.51 |
| Fort Worth, TXTexas | $532.58 | $201.27 |
| Galveston, TXTexas | $534.28 | $200.61 |
| Houston, TXTexas | $545.44 | $211.78 |
| Rest of TexasTexas | $517.74 | $198.86 |
| UtahUtah | $514.16 | $198.31 |
| VirginiaVirginia | $526.86 | $196.56 |
| Virgin Islands, VIUnited States Virgin Islands | $543.37 | $203.66 |
| VermontVermont | $525.50 | $192.84 |
| Rest of WashingtonWashington | $556.76 | $202.94 |
| King County, WAWashington | $630.05 | $217.76 |
| WisconsinWisconsin | $509.09 | $187.19 |
| West VirginiaWest Virginia | $497.58 | $205.59 |
| WyomingWyoming | $534.13 | $198.11 |
45384 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $621.70 | 1 |
| AL | $482.28 | 1 |
| AR | $475.05 | 1 |
| AZ | $524.51 | 1 |
| CA | $569.32–$715.37 | 29 |
| CO | $561.29 | 1 |
| CT | $576.11 | 1 |
| DC | $617.68 | 1 |
| DE | $533.39 | 1 |
| FL | $532.67–$586.42 | 3 |
| GA | $501.60–$550.10 | 2 |
| GU | $583.79 | 1 |
| HI | $583.79 | 1 |
| IA | $494.29 | 1 |
| ID | $497.77 | 1 |
| IL | $517.27–$568.67 | 4 |
| IN | $500.74 | 1 |
| KS | $492.22 | 1 |
| KY | $494.80 | 1 |
| LA | $494.13–$519.40 | 2 |
| MA | $557.89–$617.59 | 2 |
| MD | $543.72–$617.68 | 3 |
| ME | $500.81–$528.43 | 2 |
| MI | $508.43–$539.88 | 2 |
| MN | $536.29 | 1 |
| MO | $485.56–$520.92 | 3 |
| MS | $480.39 | 1 |
| MT | $539.38 | 1 |
| NC | $506.18 | 1 |
| ND | $527.32 | 1 |
| NE | $497.00 | 1 |
| NH | $552.72 | 1 |
| NJ | $582.26–$611.00 | 2 |
| NM | $511.44 | 1 |
| NV | $536.41 | 1 |
| NY | $514.05–$638.41 | 5 |
| OH | $505.97 | 1 |
| OK | $493.53 | 1 |
| OR | $531.83–$579.23 | 2 |
| PA | $506.62–$561.59 | 2 |
| PR | $543.37 | 1 |
| RI | $552.50 | 1 |
| SC | $507.00 | 1 |
| SD | $525.90 | 1 |
| TN | $494.82 | 1 |
| TX | $503.20–$559.78 | 8 |
| UT | $514.16 | 1 |
| VA | $526.86–$617.68 | 2 |
| VI | $543.37 | 1 |
| VT | $525.50 | 1 |
| WA | $556.76–$630.05 | 2 |
| WI | $509.09 | 1 |
| WV | $497.58 | 1 |
| WY | $534.13 | 1 |
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
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 Montana 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
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.97 | × 1.000 | 3.9700 |
| Practice expense | 11.57 | × 1.000 | 11.5700 |
| Malpractice | 0.61 | × 0.998 | 0.6088 |
| Total RVUs | 16.1488 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$539.38
Office: (3.97 × 1 + 11.57 × 1 + 0.61 × 0.998) × $33.4009 = $539.38
Facility: (3.97 × 1 + 1.51 × 1 + 0.61 × 0.998) × $33.4009 = $203.37
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
How 45384 has changed in Montana
45384 · Office / nonfacility
$539.38
Effective 2026-10-01
The base rate is $72.74 higher than on 2025-10-01, moving from $466.64 to $539.38 (15.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$466.64changed to$539.38
- 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
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$486.21changed to$466.64
- 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.
March 9, 2024
RVU24AR
$478.27changed to$486.21
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$497.36changed to$478.27
- 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
January 1, 2023
RVU23A
$517.58changed to$497.36
- 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
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$518.06changed to$517.58
- 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.
January 1, 2021
RVU21A
$494.44changed to$518.06
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.90 changed to 10.23
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$487.29changed to$494.44
- 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
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$475.96changed to$487.29
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.14 changed to 8.44
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$467.49changed to$475.96
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.07 changed to 8.14
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$528.20changed to$467.49
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 4.17 changed to 4.07
- Practice expense RVU 9.81 changed to 8.07
- Malpractice RVU 0.63 changed to 0.62
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$480.69changed to$528.20
- Conversion factor 35.9335 changed to 35.8043
- Work RVU 4.69 changed to 4.17
- Practice expense RVU 7.78 changed to 9.81
- Malpractice RVU 0.74 changed to 0.63
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$478.30changed to$480.69
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$474.85changed to$478.30
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 7.75 changed to 7.78
- Malpractice RVU 0.70 changed to 0.74
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$489.09changed to$474.85
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 8.88 changed to 7.75
- Malpractice RVU 0.73 changed to 0.70
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $489.09
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $539.38 | $203.37 | RVU26D |
| 2026-07-01 | $539.38 | $203.37 | RVU26C |
| 2026-04-01 | $539.38 | $203.37 | RVU26B |
| 2026-01-01 | $539.38 | $203.37 | RVU26A |
| 2025-10-01 | $466.64 | $218.54 | RVU25D |
| 2025-07-01 | $466.64 | $218.54 | RVU25C |
| 2025-04-01 | $466.64 | $218.54 | RVU25B |
| 2025-01-01 | $466.64 | $218.54 | RVU25A |
| 2024-10-01 | $486.21 | $223.90 | RVU24D |
| 2024-07-01 | $486.21 | $223.90 | RVU24C |
| 2024-04-01 | $486.21 | $223.90 | RVU24B |
| 2024-03-09 | $486.21 | $223.90 | RVU24AR |
| 2024-01-01 | $478.27 | $220.25 | RVU24A |
| 2023-10-01 | $497.36 | $226.27 | RVU23D |
| 2023-07-01 | $497.36 | $226.27 | RVU23C |
| 2023-04-01 | $497.36 | $226.27 | RVU23B |
| 2023-01-01 | $497.36 | $226.27 | RVU23A |
| 2022-10-01 | $517.58 | $231.38 | RVU22D |
| 2022-07-01 | $517.58 | $231.38 | RVU22C |
| 2022-04-01 | $517.58 | $231.38 | RVU22B |
| 2022-01-01 | $517.58 | $231.38 | RVU22A |
| 2021-10-01 | $518.06 | $231.24 | RVU21D |
| 2021-07-01 | $518.06 | $231.24 | RVU21C |
| 2021-04-01 | $518.06 | $231.24 | RVU21B |
| 2021-01-01 | $518.06 | $231.24 | RVU21A |
| 2020-10-01 | $494.44 | $244.34 | RVU20D |
| 2020-07-01 | $494.44 | $244.34 | RVU20C |
| 2020-04-01 | $494.44 | $244.34 | RVU20B |
| 2020-01-01 | $494.44 | $244.34 | RVU20A |
| 2019-10-01 | $487.29 | $254.84 | RVU19D |
| 2019-07-01 | $487.29 | $254.84 | RVU19C |
| 2019-04-01 | $487.29 | $254.84 | RVU19B |
| 2019-01-01 | $487.29 | $254.84 | RVU19A |
| 2018-10-01 | $475.96 | $255.64 | RVU18D |
| 2018-07-01 | $475.96 | $255.64 | RVU18C |
| 2018-04-01 | $475.96 | $255.64 | RVU18B |
| 2018-01-01 | $475.96 | $255.64 | RVU18AR1 |
| 2017-10-01 | $467.49 | $250.36 | RVU17D |
| 2017-07-01 | $467.49 | $250.36 | RVU17C |
| 2017-04-01 | $467.49 | $250.36 | RVU17B |
| 2017-01-01 | $467.49 | $250.36 | RVU17A |
| 2016-10-01 | $528.20 | $250.72 | RVU16D |
| 2016-07-01 | $528.20 | $250.72 | RVU16C |
| 2016-04-01 | $528.20 | $250.72 | RVU16B |
| 2016-01-01 | $528.20 | $250.72 | RVU16A |
| 2015-10-01 | $480.69 | $284.85 | RVU15D |
| 2015-07-01 | $480.69 | $284.85 | RVU15C |
| 2015-04-01 | $478.30 | $283.44 | RVU15B |
| 2015-01-01 | $478.30 | $283.44 | RVU15A |
| 2014-10-01 | $474.85 | $281.41 | RVU14D |
| 2014-07-01 | $474.85 | $281.41 | RVU14C |
| 2014-04-01 | $474.85 | $281.41 | RVU14B |
| 2014-01-01 | $474.85 | $281.41 | RVU14A |
| 2013-10-01 | $489.09 | $277.12 | RVU13D |
| 2013-07-01 | $489.09 | $277.12 | RVU13C |
| 2013-04-01 | $489.09 | $277.12 | RVU13B |
| 2013-01-01 | $489.09 | $277.12 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
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
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