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

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 Manhattan, NY, Medicare pays $622.46 for 45384 in the office and $232.01 when it’s performed in a hospital or facility.

$622.46Office (non-facility)
$232.01Hospital or facility
+15.4%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 Manhattan, NY
  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 Manhattan, NY 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. Manhattan, NY pays $622.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

45384 in Manhattan, NY vs other payment areas
  1. Manhattan, NY · this page$622.46
  2. NYC suburbs and Long Island, NY · New York$638.41+$15.95
  3. Poughkeepsie and northern NYC suburbs, NY · New York$586.38−$36.08
  4. Queens, NY · New York$627.25+$4.79
  5. Rest of New York · New York$514.05−$108.41
  6. Los Angeles, CA · California$608.74−$13.72
  7. Washington, DC area · District of Columbia$617.68−$4.78

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

Every other payment area

45384 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$586.42$236.63
Chicago, ILIllinois$568.67$230.98
AlaskaAlaska$621.70$263.84
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

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 Manhattan, NY 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

78

Locality
Manhattan, NY
Physician work
1.064
Practice expense
1.162
Malpractice
1.586
Office calculation for 45384 in Manhattan, NY
ComponentRVULocality factorAdjusted
Physician work3.97× 1.0644.2241
Practice expense11.57× 1.16213.4443
Malpractice0.61× 1.5860.9675
Total RVUs18.6359
Conversion factor× 33.4009

Office rate, Manhattan, NY$622.46

Office: (3.97 × 1.064 + 11.57 × 1.162 + 0.61 × 1.586) × $33.4009 = $622.46

Facility: (3.97 × 1.064 + 1.51 × 1.162 + 0.61 × 1.586) × $33.4009 = $232.01

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, Manhattan, NY
Used instead
45385Snare polypectomy, during colonoscopyColonoscopy lesion removal by snare rather than hot biopsy forceps or bipolar cautery.$573.64
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy when no therapeutic lesion removal is performed.$434.75
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.$552.32

How 45384 has changed in Manhattan, NY

45384 · Office / nonfacility

$622.46

Effective 2026-10-01

The base rate is $81.15 higher than on 2025-10-01, moving from $541.31 to $622.46 (15.0%).

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

    $541.31changed to$622.46

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.166 changed to 1.162
    • Malpractice GPCI 1.656 changed to 1.586

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $563.88changed to$541.31

    • 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

    $554.68changed to$563.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $585.61changed to$554.68

    • 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
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.184 changed to 1.166
    • Malpractice GPCI 1.843 changed to 1.656

  5. January 1, 2023

    RVU23A

    $619.71changed to$585.61

    • 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
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.203 changed to 1.184
    • Malpractice GPCI 2.031 changed to 1.843

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $619.07changed to$619.71

    • 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

    $574.53changed to$619.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.90 changed to 10.23
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.192 changed to 1.203
    • Malpractice GPCI 1.823 changed to 2.031

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $549.31changed to$574.53

    • 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
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.180 changed to 1.192
    • Malpractice GPCI 1.615 changed to 1.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $535.97changed to$549.31

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

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $531.28changed to$535.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.07 changed to 8.14
    • Practice expense GPCI 1.174 changed to 1.180
    • Malpractice GPCI 1.690 changed to 1.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $607.11changed to$531.28

    • 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
    • Practice expense GPCI 1.168 changed to 1.174
    • Malpractice GPCI 1.764 changed to 1.690

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $550.73changed to$607.11

    • 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.

  13. July 1, 2015

    RVU15C

    $547.99changed to$550.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $539.09changed to$547.99

    • 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
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.165 changed to 1.168
    • Malpractice GPCI 1.518 changed to 1.764

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $552.10changed to$539.09

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.162 changed to 1.165
    • Malpractice GPCI 1.271 changed to 1.518

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $552.10

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$622.46$232.01RVU26D
2026-07-01$622.46$232.01RVU26C
2026-04-01$622.46$232.01RVU26B
2026-01-01$622.46$232.01RVU26A
2025-10-01$541.31$252.03RVU25D
2025-07-01$541.31$252.03RVU25C
2025-04-01$541.31$252.03RVU25B
2025-01-01$541.31$252.03RVU25A
2024-10-01$563.88$258.03RVU24D
2024-07-01$563.88$258.03RVU24C
2024-04-01$563.88$258.03RVU24B
2024-03-09$563.88$258.03RVU24AR
2024-01-01$554.68$253.82RVU24A
2023-10-01$585.61$264.63RVU23D
2023-07-01$585.61$264.63RVU23C
2023-04-01$585.61$264.63RVU23B
2023-01-01$585.61$264.63RVU23A
2022-10-01$619.71$275.42RVU22D
2022-07-01$619.71$275.42RVU22C
2022-04-01$619.71$275.42RVU22B
2022-01-01$619.71$275.42RVU22A
2021-10-01$619.07$274.03RVU21D
2021-07-01$619.07$274.03RVU21C
2021-04-01$619.07$274.03RVU21B
2021-01-01$619.07$274.03RVU21A
2020-10-01$574.53$276.41RVU20D
2020-07-01$574.53$276.41RVU20C
2020-04-01$574.53$276.41RVU20B
2020-01-01$574.53$276.41RVU20A
2019-10-01$549.31$275.02RVU19D
2019-07-01$549.31$275.02RVU19C
2019-04-01$549.31$275.02RVU19B
2019-01-01$549.31$275.02RVU19A
2018-10-01$535.97$275.99RVU18D
2018-07-01$535.97$275.99RVU18C
2018-04-01$535.97$275.99RVU18B
2018-01-01$535.97$275.99RVU18AR1
2017-10-01$531.28$276.38RVU17D
2017-07-01$531.28$276.38RVU17C
2017-04-01$531.28$276.38RVU17B
2017-01-01$531.28$276.38RVU17A
2016-10-01$607.11$283.01RVU16D
2016-07-01$607.11$283.01RVU16C
2016-04-01$607.11$283.01RVU16B
2016-01-01$607.11$283.01RVU16A
2015-10-01$550.73$321.99RVU15D
2015-07-01$550.73$321.99RVU15C
2015-04-01$547.99$320.39RVU15B
2015-01-01$547.99$320.39RVU15A
2014-10-01$539.09$313.72RVU14D
2014-07-01$539.09$313.72RVU14C
2014-04-01$539.09$313.72RVU14B
2014-01-01$539.09$313.72RVU14A
2013-10-01$552.10$305.80RVU13D
2013-07-01$552.10$305.80RVU13C
2013-04-01$552.10$305.80RVU13B
2013-01-01$552.10$305.80RVU13AR

Price 45384 for an earlier date of service

Where the Manhattan, NY rate applies

Manhattan, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Manhattan, NYGPCI2026.csv, line 78 (RVU26D)

Open CMS sourceHow we calculate rates

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