CPT code 45388: Colonoscopy ablation, lesion ablation2026 Medicare rate & RVUs

Medicare pays $2,659.38 for 45388 nationally in the office and $238.48 in a hospital or facility. Local office rates run $2,299.93–$3,763.88.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 45388 covers

A gastroenterologist or colorectal surgeon uses a flexible colonoscope to destroy lesion tissue rather than remove it as a specimen. Ablation may use methods such as argon plasma coagulation or electrocautery. A typical situation is treating residual adenomatous tissue at a prior polypectomy site; the code also covers ablation of other appropriate colonic lesions. The service is performed in settings where colonoscopy is provided, including hospital outpatient departments and ambulatory surgery centers.

Report the code when lesion destruction is performed, and document the lesion treated and the ablation method. When related endoscopies are performed together, CMS applies endoscopy-family pricing. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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.

Where 45388 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

45388 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 45388 rate is calculated

Each of 45388’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.

Payment rules and modifiers for 45388

The CMS indicators that decide how 45388 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

45388 compared with similar codes

How to choose

45384Colonoscopy polyp removalHot biopsy or bipolar cautery

Use 45384 when hot biopsy forceps or bipolar cautery removes lesion tissue. Use 45388 when the treatment destroys the lesion rather than removing it.

45385Snare polypectomyDuring colonoscopy

Use 45385 for snare removal of a lesion. Ablation without snare excision is reported with 45388.

45382ColonoscopyControl of bleeding

Use 45382 when the service is directed at controlling bleeding. Use 45388 when the intent is to ablate a tumor, polyp, or other lesion.

45346Flexible sigmoidoscopyLesion ablation

Both codes describe endoscopic lesion ablation; 45346 is for flexible sigmoidoscopy, while 45388 is for colonoscopy.

Codes related to 45388

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

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

Open CMS sourceHow we calculate rates