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CPT code 45385: Snare polypectomy, during colonoscopy2026 Medicare rate & RVUs in North Carolina

Report 45385 when one or more polyps or other lesions are removed during flexible colonoscopy with a wire snare, with or without cautery.

CMS RVU26DEffective Oct 1, 2026One payment locality1.6M Medicare services in 2024

In North Carolina, Medicare pays $471.48 for 45385 in the office and $213.45 when it’s performed in a hospital or facility.

$471.48Office (non-facility)
$213.45Hospital or facility
−5.7%vs the national office rate ($500.01)

Check a contract rate as a % of Medicare · 45385 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 45385 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 45385 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 45385 covers

During this procedure, a gastroenterologist or colorectal surgeon advances a flexible colonoscope through the colon, typically to the cecum. Polyps or other lesions are captured with a wire snare and removed either cold or with electrocautery. Removed tissue is typically submitted for pathology. Most cases occur in hospital outpatient departments and ambulatory surgery centers, with a smaller share in office endoscopy suites. Common situations include screening colonoscopies that uncover adenomas, surveillance after prior polyps, and evaluation of a positive stool test.

Report one unit per session regardless of how many lesions are snared. The procedure report should identify the removal technique, lesion sites and sizes, exam extent, and bowel prep quality. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing uses diagnostic colonoscopy 45378 as the base to calculate payment for additional procedures. Medicare does not pay an assistant at surgery for 45385; co-surgeons and team surgery are not permitted. Because the colon is not a bilateral structure, modifier 50 is inappropriate.

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 North Carolina compares for 45385

Across 109 of 109 payment localities, the office rate for 45385 runs from $444.65 in Arkansas to $656.13 in San Benito County, CA. North Carolina pays $471.48. The RVUs are the same everywhere; the geographic indexes change the dollars.

45385 in North Carolina vs other payment areas
  1. North Carolina · this page$471.48
  2. Los Angeles, CA · California$561.52+$90.04
  3. Washington, DC area · District of Columbia$569.43+$97.95
  4. Miami, FL · Florida$539.75+$68.27
  5. Chicago, IL · Illinois$524.78+$53.30
  6. Manhattan, NY · New York$573.64+$102.16
  7. Alaska · Alaska$588.56+$117.08

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

Every other payment area

45385 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$450.87$208.88
ArkansasArkansas$444.65$207.09
ArizonaArizona$487.20$219.22
Bakersfield, CACalifornia$528.25$225.14
Chico, CACalifornia$526.70$223.60
El Centro, CACalifornia$526.79$223.68
Fresno, CACalifornia$526.70$223.60
Hanford, CACalifornia$526.70$223.60

45385 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.

$444.65

$591.42

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

View every state and territory as a table
45385 office rate range by state
State / territoryOffice rate rangeLocalities
AK$588.561
AL$450.871
AR$444.651
AZ$487.201
CA$526.70–$656.1329
CO$519.451
CT$532.291
DC$569.431
DE$495.031
FL$493.88–$539.753
GA$467.21–$509.232
GU$538.601
HI$538.601
IA$461.351
ID$464.311
IL$480.54–$524.784
IN$466.871
KS$459.501
KY$461.491
LA$460.88–$482.622
MA$516.64–$569.042
MD$504.11–$569.433
ME$466.85–$490.722
MI$473.15–$500.012
MN$497.711
MO$453.48–$484.013
MS$449.141
MT$499.981
NC$471.481
ND$489.891
NE$463.701
NH$511.581
NJ$538.35–$564.002
NM$475.711
NV$497.501
NY$478.25–$587.275
OH$471.091
OK$460.471
OR$493.62–$535.112
PA$471.69–$519.672
PR$503.431
RI$512.021
SC$472.071
SD$488.701
TN$461.731
TX$468.74–$517.748
UT$478.231
VA$489.33–$569.432
VI$503.431
VT$488.261
WA$515.58–$580.162
WI$474.201
WV$463.601
WY$495.581

See 45385 in every payment locality

How the 45385 rate is calculated

Each of 45385’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 · 45385

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.46

4.46 RVUs× 1.000 GPCI

Practice expense10.00

10.00 RVUs× 1.000 GPCI

Malpractice0.51

0.51 RVUs× 1.000 GPCI

Adjusted RVUs

14.9700

Conversion factor

$33.4009

Medicare rate

$500.01

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,520

Code
45385
Physician work
4.46
Practice expense
10.00
Malpractice
0.51

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 45385 in North Carolina
ComponentRVULocality factorAdjusted
Physician work4.46× 1.0004.4600
Practice expense10.00× 0.9339.3300
Malpractice0.51× 0.6390.3259
Total RVUs14.1159
Conversion factor× 33.4009

Office rate, North Carolina$471.48

Office: (4.46 × 1 + 10 × 0.933 + 0.51 × 0.639) × $33.4009 = $471.48

Facility: (4.46 × 1 + 1.72 × 0.933 + 0.51 × 0.639) × $33.4009 = $213.45

Open 45385 in the RVU calculator

Payment rules and modifiers for 45385

The CMS indicators that decide how 45385 is paid alongside other services.

CMS payment indicators · 45385

Snare polypectomy, during colonoscopy

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

45385 without 51 · national office

$500.01

Snare polypectomy, during colonoscopy

45385-51 · Second procedure: 50%

$250.01

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 45385

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

Codes related to 45385
CodeHow it relatesOffice range, North Carolina
Same family
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy; included in 45385 and used as the base for endoscopy family pricing.$355.86
45384Colonoscopy polyp removal, hot biopsy or bipolar cauteryLesion removal by hot biopsy forceps or bipolar cautery rather than snare.$506.18
Often billed with
45380Colonoscopy with biopsy, single or multiple forceps biopsiesBiopsy of a separate lesion during the same colonoscopy may be reported with modifier 59.$451.45
45381Colonoscopy injection, directed submucosal injectionSubmucosal injection, such as documented tattooing of the polypectomy site.$461.11
45382Colonoscopy, control of bleedingControl of bleeding at a separate site; treatment of bleeding caused by polypectomy is included.$686.47
Used instead
45390Colonoscopy, mucosal lesion resectionEndoscopic mucosal resection rather than conventional snare removal.No office rate
45388Colonoscopy ablation, lesion ablationAblation of a lesion when removal by snare or other specified methods is not feasible.$2,485.96

How 45385 has changed in North Carolina

45385 · Office / nonfacility

$471.48

Effective 2026-10-01

The base rate is $62.10 higher than on 2025-10-01, moving from $409.38 to $471.48 (15.2%).

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

    $409.38changed to$471.48

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.57 changed to 4.46
    • Practice expense RVU 8.33 changed to 10.00
    • Malpractice RVU 0.56 changed to 0.51
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $425.60changed to$409.38

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.47 changed to 8.33

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $418.65changed to$425.60

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $435.39changed to$418.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.49 changed to 8.47
    • Malpractice RVU 0.55 changed to 0.56
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $453.49changed to$435.39

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.72 changed to 8.49
    • Malpractice RVU 0.54 changed to 0.55
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $453.16changed to$453.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.62 changed to 8.72
    • Malpractice RVU 0.51 changed to 0.54

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $433.55changed to$453.16

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.58 changed to 8.62
    • Malpractice RVU 0.52 changed to 0.51
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $421.55changed to$433.55

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.20 changed to 7.58
    • Malpractice RVU 0.61 changed to 0.52
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $412.71changed to$421.55

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.95 changed to 7.20

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $410.92changed to$412.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.91 changed to 6.95
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $472.89changed to$410.92

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.67 changed to 4.57
    • Practice expense RVU 8.66 changed to 6.91
    • Malpractice RVU 0.63 changed to 0.61
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $505.99changed to$472.89

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 5.30 changed to 4.67
    • Practice expense RVU 8.79 changed to 8.66
    • Malpractice RVU 0.79 changed to 0.63

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $503.48changed to$505.99

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $501.25changed to$503.48

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.75 changed to 8.79
    • Malpractice RVU 0.77 changed to 0.79
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $517.16changed to$501.25

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.08 changed to 8.75
    • Malpractice RVU 0.80 changed to 0.77
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $517.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$471.48$213.45RVU26D
2026-07-01$471.48$213.45RVU26C
2026-04-01$471.48$213.45RVU26B
2026-01-01$471.48$213.45RVU26A
2025-10-01$409.38$231.16RVU25D
2025-07-01$409.38$231.16RVU25C
2025-04-01$409.38$231.16RVU25B
2025-01-01$409.38$231.16RVU25A
2024-10-01$425.60$237.27RVU24D
2024-07-01$425.60$237.27RVU24C
2024-04-01$425.60$237.27RVU24B
2024-03-09$425.60$237.27RVU24AR
2024-01-01$418.65$233.39RVU24A
2023-10-01$435.39$241.89RVU23D
2023-07-01$435.39$241.89RVU23C
2023-04-01$435.39$241.89RVU23B
2023-01-01$435.39$241.89RVU23A
2022-10-01$453.49$248.60RVU22D
2022-07-01$453.49$248.60RVU22C
2022-04-01$453.49$248.60RVU22B
2022-01-01$453.49$248.60RVU22A
2021-10-01$453.16$248.84RVU21D
2021-07-01$453.16$248.84RVU21C
2021-04-01$453.16$248.84RVU21B
2021-01-01$453.16$248.84RVU21A
2020-10-01$433.55$254.99RVU20D
2020-07-01$433.55$254.99RVU20C
2020-04-01$433.55$254.99RVU20B
2020-01-01$433.55$254.99RVU20A
2019-10-01$421.55$256.14RVU19D
2019-07-01$421.55$256.14RVU19C
2019-04-01$421.55$256.14RVU19B
2019-01-01$421.55$256.14RVU19A
2018-10-01$412.71$256.87RVU18D
2018-07-01$412.71$256.87RVU18C
2018-04-01$412.71$256.87RVU18B
2018-01-01$412.71$256.87RVU18AR1
2017-10-01$410.92$256.88RVU17D
2017-07-01$410.92$256.88RVU17C
2017-04-01$410.92$256.88RVU17B
2017-01-01$410.92$256.88RVU17A
2016-10-01$472.89$262.45RVU16D
2016-07-01$472.89$262.45RVU16C
2016-04-01$472.89$262.45RVU16B
2016-01-01$472.89$262.45RVU16A
2015-10-01$505.99$302.14RVU15D
2015-07-01$505.99$302.14RVU15C
2015-04-01$503.48$300.64RVU15B
2015-01-01$503.48$300.64RVU15A
2014-10-01$501.25$300.24RVU14D
2014-07-01$501.25$300.24RVU14C
2014-04-01$501.25$300.24RVU14B
2014-01-01$501.25$300.24RVU14A
2013-10-01$517.16$296.06RVU13D
2013-07-01$517.16$296.06RVU13C
2013-04-01$517.16$296.06RVU13B
2013-01-01$517.16$296.06RVU13AR

Price 45385 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

45385 billing questions

How many units are reported when several polyps are removed by snare?

One unit. The code covers all lesions removed by snare during the session, regardless of their number or location.

Can 45380 be reported with 45385 in the same session?

Yes, when a separate lesion is biopsied. Use modifier 59 on 45380 when needed to identify the distinct lesion; a biopsy of the lesion subsequently removed by snare is included in 45385.

What happens when a Medicare screening colonoscopy turns into a polypectomy?

Report 45385 instead of the screening G code and append modifier PT to identify the procedure as a screening that became therapeutic. The Medicare screening-related deductible waiver then applies.

Should 45385 or 45390 be reported when a polyp is lifted with an injection before snaring?

An injection lift alone does not establish endoscopic mucosal resection. Report 45390 when the procedure report supports that resection technique; do not add 45385 or 45381 for the same lesion's resection and lift.

Can a tattoo injection be added to 45385?

A documented submucosal ink injection to mark the polypectomy site may be reported with 45381. When both services are payable, endoscopy family pricing applies.

How do snare and hot biopsy forceps removal differ for coding?

Snare removal, hot or cold, is reported with 45385. Removal with hot biopsy forceps or bipolar cautery is reported with 45384; when different lesions are treated by both methods, a distinct-procedure modifier may be needed.

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 45385PPRRVU2026_Oct_nonQPP.csv, line 5,520 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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