CPT code 45388: Colonoscopy ablation, lesion ablation2026 Medicare rate & RVUs in Miami, FL
Reports colonoscopic destruction of a tumor, polyp, or other lesion, such as residual adenomatous tissue treated with endoscopic energy.
In Miami, FL, Medicare pays $2,791.72 for 45388 in the office and $271.56 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 45388 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 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.
How Miami, FL compares for 45388
Across 109 of 109 payment localities, the office rate for 45388 runs from $2,299.93 in Arkansas to $3,763.88 in San Benito County, CA. Miami, FL pays $2,791.72. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Miami, FL · this page$2,791.72
- Fort Lauderdale, FL · Florida$2,707.82−$83.90
- Rest of Florida · Florida$2,560.32−$231.40
- Los Angeles, CA · California$3,113.07+$321.35
- Washington, DC area · District of Columbia$3,111.73+$320.01
- Chicago, IL · Illinois$2,698.85−$92.87
- Manhattan, NY · New York$3,083.12+$291.40
Other areas in Florida first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $2,891.10 | $312.84 |
| AlabamaAlabama | $2,340.64 | $222.35 |
| ArkansasArkansas | $2,299.93 | $220.38 |
| ArizonaArizona | $2,579.60 | $233.75 |
| Bakersfield, CACalifornia | $2,892.68 | $239.37 |
| Chico, CACalifornia | $2,890.90 | $237.59 |
| El Centro, CACalifornia | $2,891.00 | $237.69 |
| Fresno, CACalifornia | $2,890.90 | $237.59 |
| Hanford, CACalifornia | $2,890.90 | $237.59 |
| Madera, CACalifornia | $2,890.90 | $237.59 |
| Merced, CACalifornia | $2,890.90 | $237.59 |
| Modesto, CACalifornia | $2,890.90 | $237.59 |
| Napa, CACalifornia | $3,448.29 | $257.54 |
| Oxnard, CACalifornia | $3,107.70 | $246.20 |
| Redding, CACalifornia | $2,890.90 | $237.59 |
| Rest of CaliforniaCalifornia | $2,890.90 | $237.59 |
| Riverside, CACalifornia | $2,897.41 | $244.11 |
| Sacramento, CACalifornia | $3,060.10 | $244.60 |
| Salinas, CACalifornia | $3,049.39 | $243.57 |
| San Diego, CACalifornia | $3,141.12 | $245.73 |
| Marin County, CACalifornia | $3,680.59 | $267.12 |
| San Francisco, CACalifornia | $3,679.90 | $266.44 |
| San Benito County, CACalifornia | $3,763.88 | $272.95 |
| Santa Clara County, CACalifornia | $3,761.10 | $270.17 |
| San Luis Obispo, CACalifornia | $2,997.55 | $240.15 |
| Santa Cruz, CACalifornia | $3,186.70 | $245.30 |
| Santa Maria, CACalifornia | $3,066.27 | $243.50 |
| Santa Rosa, CACalifornia | $3,220.37 | $247.51 |
| Stockton, CACalifornia | $2,890.90 | $237.59 |
| Vallejo, CACalifornia | $3,447.31 | $256.56 |
| Visalia, CACalifornia | $2,890.90 | $237.59 |
| Yuba City, CACalifornia | $2,890.90 | $237.59 |
| ColoradoColorado | $2,815.64 | $239.81 |
| ConnecticutConnecticut | $2,857.75 | $250.45 |
| DelawareDelaware | $2,628.39 | $236.54 |
| Atlanta, GAGeorgia | $2,703.57 | $243.94 |
| Rest of GeorgiaGeorgia | $2,395.35 | $235.91 |
| Hawaii, Guam, HIHawaii | $2,990.75 | $238.19 |
| IowaIowa | $2,436.47 | $221.34 |
| IdahoIdaho | $2,450.39 | $223.16 |
| East St. Louis, ILIllinois | $2,481.27 | $254.05 |
| Rest of IllinoisIllinois | $2,454.87 | $244.59 |
| Suburban Chicago, ILIllinois | $2,742.93 | $256.67 |
| IndianaIndiana | $2,468.01 | $223.84 |
| KansasKansas | $2,411.33 | $222.83 |
| KentuckyKentucky | $2,382.36 | $230.18 |
| New Orleans, LALouisiana | $2,515.76 | $237.70 |
| Rest of LouisianaLouisiana | $2,373.30 | $230.80 |
| Metropolitan Boston, MAMassachusetts | $3,144.88 | $254.33 |
| Rest of MassachusettsMassachusetts | $2,789.31 | $240.11 |
| Baltimore area, MDMaryland | $2,847.74 | $250.12 |
| Rest of MarylandMaryland | $2,689.09 | $239.14 |
| Rest of MaineMaine | $2,453.38 | $226.15 |
| Southern Maine, MEMaine | $2,629.66 | $230.55 |
| Detroit, MIMichigan | $2,586.32 | $250.15 |
| Rest of MichiganMichigan | $2,446.17 | $235.90 |
| MinnesotaMinnesota | $2,717.20 | $226.10 |
| Metropolitan Kansas City, MOMissouri | $2,507.62 | $234.39 |
| Metropolitan St. Louis, MOMissouri | $2,540.36 | $235.67 |
| Rest of MissouriMissouri | $2,316.57 | $229.76 |
| MississippiMississippi | $2,309.38 | $224.99 |
| MontanaMontana | $2,659.34 | $238.44 |
| North CarolinaNorth Carolina | $2,485.96 | $227.26 |
| North DakotaNorth Dakota | $2,647.48 | $226.58 |
| NebraskaNebraska | $2,455.93 | $221.44 |
| New HampshireNew Hampshire | $2,758.57 | $238.41 |
| Northern New JerseyNew Jersey | $3,067.61 | $259.37 |
| Rest of New JerseyNew Jersey | $2,895.88 | $252.26 |
| New MexicoNew Mexico | $2,457.54 | $237.58 |
| NevadaNevada | $2,658.51 | $235.20 |
| NYC suburbs and Long Island, NYNew York | $3,155.52 | $277.07 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $2,906.38 | $255.49 |
| Queens, NYNew York | $3,129.84 | $268.34 |
| Rest of New YorkNew York | $2,529.41 | $229.56 |
| OhioOhio | $2,443.75 | $233.47 |
| OklahomaOklahoma | $2,389.51 | $227.65 |
| Portland, OROregon | $2,932.11 | $242.50 |
| Rest of OregonOregon | $2,643.51 | $232.29 |
| Metropolitan Philadelphia, PAPennsylvania | $2,767.80 | $247.65 |
| Rest of PennsylvaniaPennsylvania | $2,454.89 | $232.51 |
| Puerto RicoPuerto Rico | $2,686.36 | $238.84 |
| Rhode IslandRhode Island | $2,742.09 | $241.30 |
| South CarolinaSouth Carolina | $2,467.87 | $230.96 |
| South DakotaSouth Dakota | $2,646.07 | $225.18 |
| TennesseeTennessee | $2,424.39 | $223.79 |
| Austin, TXTexas | $2,801.27 | $239.96 |
| Beaumont, TXTexas | $2,434.73 | $231.71 |
| Brazoria, TXTexas | $2,633.92 | $234.81 |
| Dallas, TXTexas | $2,648.04 | $236.83 |
| Fort Worth, TXTexas | $2,623.50 | $236.50 |
| Galveston, TXTexas | $2,639.84 | $235.89 |
| Houston, TXTexas | $2,650.82 | $246.87 |
| Rest of TexasTexas | $2,530.94 | $233.51 |
| UtahUtah | $2,508.51 | $232.87 |
| VirginiaVirginia | $2,611.32 | $231.58 |
| Virgin Islands, VIUnited States Virgin Islands | $2,686.36 | $238.84 |
| VermontVermont | $2,624.68 | $227.99 |
| Rest of WashingtonWashington | $2,788.12 | $238.91 |
| King County, WAWashington | $3,226.70 | $256.26 |
| WisconsinWisconsin | $2,541.34 | $222.12 |
| West VirginiaWest Virginia | $2,343.09 | $239.33 |
| WyomingWyoming | $2,654.17 | $233.27 |
45388 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.
$2,299.93
$3,327.39
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 | $2,891.10 | 1 |
| AL | $2,340.64 | 1 |
| AR | $2,299.93 | 1 |
| AZ | $2,579.60 | 1 |
| CA | $2,890.90–$3,763.88 | 29 |
| CO | $2,815.64 | 1 |
| CT | $2,857.75 | 1 |
| DC | $3,111.73 | 1 |
| DE | $2,628.39 | 1 |
| FL | $2,560.32–$2,791.72 | 3 |
| GA | $2,395.35–$2,703.57 | 2 |
| GU | $2,990.75 | 1 |
| HI | $2,990.75 | 1 |
| IA | $2,436.47 | 1 |
| ID | $2,450.39 | 1 |
| IL | $2,454.87–$2,742.93 | 4 |
| IN | $2,468.01 | 1 |
| KS | $2,411.33 | 1 |
| KY | $2,382.36 | 1 |
| LA | $2,373.30–$2,515.76 | 2 |
| MA | $2,789.31–$3,144.88 | 2 |
| MD | $2,689.09–$3,111.73 | 3 |
| ME | $2,453.38–$2,629.66 | 2 |
| MI | $2,446.17–$2,586.32 | 2 |
| MN | $2,717.20 | 1 |
| MO | $2,316.57–$2,540.36 | 3 |
| MS | $2,309.38 | 1 |
| MT | $2,659.34 | 1 |
| NC | $2,485.96 | 1 |
| ND | $2,647.48 | 1 |
| NE | $2,455.93 | 1 |
| NH | $2,758.57 | 1 |
| NJ | $2,895.88–$3,067.61 | 2 |
| NM | $2,457.54 | 1 |
| NV | $2,658.51 | 1 |
| NY | $2,529.41–$3,155.52 | 5 |
| OH | $2,443.75 | 1 |
| OK | $2,389.51 | 1 |
| OR | $2,643.51–$2,932.11 | 2 |
| PA | $2,454.89–$2,767.80 | 2 |
| PR | $2,686.36 | 1 |
| RI | $2,742.09 | 1 |
| SC | $2,467.87 | 1 |
| SD | $2,646.07 | 1 |
| TN | $2,424.39 | 1 |
| TX | $2,434.73–$2,801.27 | 8 |
| UT | $2,508.51 | 1 |
| VA | $2,611.32–$3,111.73 | 2 |
| VI | $2,686.36 | 1 |
| VT | $2,624.68 | 1 |
| WA | $2,788.12–$3,226.70 | 2 |
| WI | $2,541.34 | 1 |
| WV | $2,343.09 | 1 |
| WY | $2,654.17 | 1 |
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.
How the rate is built · 45388
RVUs × geographic indexes × conversion factor
Work4.76
4.76 RVUs× 1.000 GPCI
Practice expense74.26
74.26 RVUs× 1.000 GPCI
Malpractice0.60
0.60 RVUs× 1.000 GPCI
Adjusted RVUs
79.6200
Conversion factor
$33.4009
Medicare rate
$2,659.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Miami, FL inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,522
- Code
- 45388
- Physician work
- 4.76
- Practice expense
- 74.26
- Malpractice
- 0.60
GPCI2026.csv
42
- Locality
- Miami, FL
- Physician work
- 1.000
- Practice expense
- 1.041
- Malpractice
- 2.529
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.76 | × 1.000 | 4.7600 |
| Practice expense | 74.26 | × 1.041 | 77.3047 |
| Malpractice | 0.60 | × 2.529 | 1.5174 |
| Total RVUs | 83.5821 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Miami, FL$2791.72
Office: (4.76 × 1 + 74.26 × 1.041 + 0.6 × 2.529) × $33.4009 = $2791.72
Facility: (4.76 × 1 + 1.78 × 1.041 + 0.6 × 2.529) × $33.4009 = $271.56
Payment rules and modifiers for 45388
The CMS indicators that decide how 45388 is paid alongside other services.
CMS payment indicators · 45388
Colonoscopy ablation, lesion ablation
| 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
45388 without 51 · national office
$2,659.38
Colonoscopy ablation, lesion ablation
45388-51 · Second procedure: 50%
$1,329.69
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 45388 has changed in Miami, FL
45388 · Office / nonfacility
$2791.72
Effective 2026-10-01
The base rate is $472.13 higher than on 2025-10-01, moving from $2319.59 to $2791.72 (20.4%).
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
$2319.59changed to$2791.72
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.88 changed to 4.76
- Practice expense RVU 63.54 changed to 74.26
- Malpractice RVU 0.63 changed to 0.60
- Practice expense GPCI 1.027 changed to 1.041
- Malpractice GPCI 2.500 changed to 2.529
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$2505.01changed to$2319.59
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 66.99 changed to 63.54
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$2464.12changed to$2505.01
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$2607.92changed to$2464.12
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 68.72 changed to 66.99
- Malpractice RVU 0.64 changed to 0.63
- Practice expense GPCI 1.025 changed to 1.027
- Malpractice GPCI 2.564 changed to 2.500
January 1, 2023
RVU23A
$2777.02changed to$2607.92
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 72.13 changed to 68.72
- Malpractice RVU 0.60 changed to 0.64
- Practice expense GPCI 1.023 changed to 1.025
- Malpractice GPCI 2.629 changed to 2.564
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$3060.06changed to$2777.02
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 79.44 changed to 72.13
- Malpractice RVU 0.59 changed to 0.60
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$3099.08changed to$3060.06
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 77.42 changed to 79.44
- Malpractice RVU 0.60 changed to 0.59
- Practice expense GPCI 1.026 changed to 1.023
- Malpractice GPCI 2.598 changed to 2.629
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$3254.07changed to$3099.08
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 81.31 changed to 77.42
- Malpractice RVU 0.68 changed to 0.60
- Practice expense GPCI 1.029 changed to 1.026
- Malpractice GPCI 2.566 changed to 2.598
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$3432.20changed to$3254.07
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 86.19 changed to 81.31
- Malpractice RVU 0.69 changed to 0.68
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$3397.27changed to$3432.20
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 85.39 changed to 86.19
- Practice expense GPCI 1.031 changed to 1.029
- Malpractice GPCI 2.528 changed to 2.566
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$3468.25changed to$3397.27
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 4.98 changed to 4.88
- Practice expense RVU 87.24 changed to 85.39
- Malpractice RVU 0.71 changed to 0.69
- Practice expense GPCI 1.033 changed to 1.031
- Malpractice GPCI 2.490 changed to 2.528
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$3468.25
Held through RVU16B, RVU16C, RVU16D.
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $2,791.72 | $271.56 | RVU26D |
| 2026-07-01 | $2,791.72 | $271.56 | RVU26C |
| 2026-04-01 | $2,791.72 | $271.56 | RVU26B |
| 2026-01-01 | $2,791.72 | $271.56 | RVU26A |
| 2025-10-01 | $2,319.59 | $291.18 | RVU25D |
| 2025-07-01 | $2,319.59 | $291.18 | RVU25C |
| 2025-04-01 | $2,319.59 | $291.18 | RVU25B |
| 2025-01-01 | $2,319.59 | $291.18 | RVU25A |
| 2024-10-01 | $2,505.01 | $298.97 | RVU24D |
| 2024-07-01 | $2,505.01 | $298.97 | RVU24C |
| 2024-04-01 | $2,505.01 | $298.97 | RVU24B |
| 2024-03-09 | $2,505.01 | $298.97 | RVU24AR |
| 2024-01-01 | $2,464.12 | $294.09 | RVU24A |
| 2023-10-01 | $2,607.92 | $305.38 | RVU23D |
| 2023-07-01 | $2,607.92 | $305.38 | RVU23C |
| 2023-04-01 | $2,607.92 | $305.38 | RVU23B |
| 2023-01-01 | $2,607.92 | $305.38 | RVU23A |
| 2022-10-01 | $2,777.02 | $309.49 | RVU22D |
| 2022-07-01 | $2,777.02 | $309.49 | RVU22C |
| 2022-04-01 | $2,777.02 | $309.49 | RVU22B |
| 2022-01-01 | $2,777.02 | $309.49 | RVU22A |
| 2021-10-01 | $3,060.06 | $310.43 | RVU21D |
| 2021-07-01 | $3,060.06 | $310.43 | RVU21C |
| 2021-04-01 | $3,060.06 | $310.43 | RVU21B |
| 2021-01-01 | $3,060.06 | $310.43 | RVU21A |
| 2020-10-01 | $3,099.08 | $319.39 | RVU20D |
| 2020-07-01 | $3,099.08 | $319.39 | RVU20C |
| 2020-04-01 | $3,099.08 | $319.39 | RVU20B |
| 2020-01-01 | $3,099.08 | $319.39 | RVU20A |
| 2019-10-01 | $3,254.07 | $326.27 | RVU19D |
| 2019-07-01 | $3,254.07 | $326.27 | RVU19C |
| 2019-04-01 | $3,254.07 | $326.27 | RVU19B |
| 2019-01-01 | $3,254.07 | $326.27 | RVU19A |
| 2018-10-01 | $3,432.20 | $327.95 | RVU18D |
| 2018-07-01 | $3,432.20 | $327.95 | RVU18C |
| 2018-04-01 | $3,432.20 | $327.95 | RVU18B |
| 2018-01-01 | $3,432.20 | $327.95 | RVU18AR1 |
| 2017-10-01 | $3,397.27 | $326.17 | RVU17D |
| 2017-07-01 | $3,397.27 | $326.17 | RVU17C |
| 2017-04-01 | $3,397.27 | $326.17 | RVU17B |
| 2017-01-01 | $3,397.27 | $326.17 | RVU17A |
| 2016-10-01 | $3,468.25 | $331.11 | RVU16D |
| 2016-07-01 | $3,468.25 | $331.11 | RVU16C |
| 2016-04-01 | $3,468.25 | $331.11 | RVU16B |
| 2016-01-01 | $3,468.25 | $331.11 | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Miami, FL rate applies
Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.
- Miami
- Aventura
- Bal Harbour
- Bay Harbor Islands
- Big Coppitt Key
- Big Pine Key
- Biscayne Gardens
- Biscayne Park
45388 billing questions
How is ablation different from lesion removal?
Ablation destroys lesion tissue; removal techniques such as forceps or snare excision take tissue out. Choose the code that matches the technique documented.
Can diagnostic colonoscopy be reported separately?
Do not separately report a diagnostic colonoscopy for the same examination when lesion ablation is performed. The diagnostic inspection is part of the therapeutic colonoscopy.
Should modifier 50 be appended for treatment on both sides of the colon?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included. Care on a later date is outside this 0-day global period.
How are related endoscopies priced when performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed in the same session.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery 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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