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

Reports colonoscopic destruction of a tumor, polyp, or other lesion, such as residual adenomatous tissue treated with endoscopic energy.

CMS RVU26DEffective Oct 1, 2026One payment locality20.7K Medicare services in 2024

In Vermont, Medicare pays $2,624.68 for 45388 in the office and $227.99 when it’s performed in a hospital or facility.

$2,624.68Office (non-facility)
$227.99Hospital or facility
−1.3%vs the national office rate ($2,659.38)

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.

We’ll open 45388 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 45388 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 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 Vermont 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. Vermont pays $2,624.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

45388 in Vermont vs other payment areas
  1. Vermont · this page$2,624.68
  2. Los Angeles, CA · California$3,113.07+$488.39
  3. Washington, DC area · District of Columbia$3,111.73+$487.05
  4. Miami, FL · Florida$2,791.72+$167.04
  5. Chicago, IL · Illinois$2,698.85+$74.17
  6. Manhattan, NY · New York$3,083.12+$458.44
  7. Alaska · Alaska$2,891.10+$266.42

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

Every other payment area

45388 in every other Medicare payment locality
Payment localityOfficeFacility
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

45388 rates by state

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

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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
45388 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,891.101
AL$2,340.641
AR$2,299.931
AZ$2,579.601
CA$2,890.90–$3,763.8829
CO$2,815.641
CT$2,857.751
DC$3,111.731
DE$2,628.391
FL$2,560.32–$2,791.723
GA$2,395.35–$2,703.572
GU$2,990.751
HI$2,990.751
IA$2,436.471
ID$2,450.391
IL$2,454.87–$2,742.934
IN$2,468.011
KS$2,411.331
KY$2,382.361
LA$2,373.30–$2,515.762
MA$2,789.31–$3,144.882
MD$2,689.09–$3,111.733
ME$2,453.38–$2,629.662
MI$2,446.17–$2,586.322
MN$2,717.201
MO$2,316.57–$2,540.363
MS$2,309.381
MT$2,659.341
NC$2,485.961
ND$2,647.481
NE$2,455.931
NH$2,758.571
NJ$2,895.88–$3,067.612
NM$2,457.541
NV$2,658.511
NY$2,529.41–$3,155.525
OH$2,443.751
OK$2,389.511
OR$2,643.51–$2,932.112
PA$2,454.89–$2,767.802
PR$2,686.361
RI$2,742.091
SC$2,467.871
SD$2,646.071
TN$2,424.391
TX$2,434.73–$2,801.278
UT$2,508.511
VA$2,611.32–$3,111.732
VI$2,686.361
VT$2,624.681
WA$2,788.12–$3,226.702
WI$2,541.341
WV$2,343.091
WY$2,654.171

See 45388 in every payment locality

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

Office or facility?

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 45388 in Vermont
ComponentRVULocality factorAdjusted
Physician work4.76× 1.0004.7600
Practice expense74.26× 0.99073.5174
Malpractice0.60× 0.5060.3036
Total RVUs78.5810
Conversion factor× 33.4009

Office rate, Vermont$2624.68

Office: (4.76 × 1 + 74.26 × 0.99 + 0.6 × 0.506) × $33.4009 = $2624.68

Facility: (4.76 × 1 + 1.78 × 0.99 + 0.6 × 0.506) × $33.4009 = $227.99

Open 45388 in the RVU calculator

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

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

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%).

When to use modifier 51

How 45388 has changed in Vermont

45388 · Office / nonfacility

$2624.68

Effective 2026-10-01

The base rate is $415.36 higher than on 2025-10-01, moving from $2209.32 to $2624.68 (18.8%).

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

    $2209.32changed to$2624.68

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $2387.63changed to$2209.32

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 66.99 changed to 63.54

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $2348.66changed to$2387.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2498.89changed to$2348.66

    • 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 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $2679.33changed to$2498.89

    • 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 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $2956.67changed to$2679.33

    • 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.

  7. January 1, 2021

    RVU21A

    $3005.13changed to$2956.67

    • 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 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $3164.75changed to$3005.13

    • 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 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $3339.81changed to$3164.75

    • 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.

  10. January 1, 2018

    RVU18AR1

    $3286.14changed to$3339.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 85.39 changed to 86.19
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $3331.70changed to$3286.14

    • 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 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$3331.70

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2015

    RVU15A

    No ratechanged toNo rate

    Held through RVU15B, RVU15C, RVU15D.

  14. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2,624.68$227.99RVU26D
2026-07-01$2,624.68$227.99RVU26C
2026-04-01$2,624.68$227.99RVU26B
2026-01-01$2,624.68$227.99RVU26A
2025-10-01$2,209.32$248.06RVU25D
2025-07-01$2,209.32$248.06RVU25C
2025-04-01$2,209.32$248.06RVU25B
2025-01-01$2,209.32$248.06RVU25A
2024-10-01$2,387.63$254.62RVU24D
2024-07-01$2,387.63$254.62RVU24C
2024-04-01$2,387.63$254.62RVU24B
2024-03-09$2,387.63$254.62RVU24AR
2024-01-01$2,348.66$250.46RVU24A
2023-10-01$2,498.89$259.24RVU23D
2023-07-01$2,498.89$259.24RVU23C
2023-04-01$2,498.89$259.24RVU23B
2023-01-01$2,498.89$259.24RVU23A
2022-10-01$2,679.33$264.87RVU22D
2022-07-01$2,679.33$264.87RVU22C
2022-04-01$2,679.33$264.87RVU22B
2022-01-01$2,679.33$264.87RVU22A
2021-10-01$2,956.67$266.17RVU21D
2021-07-01$2,956.67$266.17RVU21C
2021-04-01$2,956.67$266.17RVU21B
2021-01-01$2,956.67$266.17RVU21A
2020-10-01$3,005.13$274.21RVU20D
2020-07-01$3,005.13$274.21RVU20C
2020-04-01$3,005.13$274.21RVU20B
2020-01-01$3,005.13$274.21RVU20A
2019-10-01$3,164.75$276.78RVU19D
2019-07-01$3,164.75$276.78RVU19C
2019-04-01$3,164.75$276.78RVU19B
2019-01-01$3,164.75$276.78RVU19A
2018-10-01$3,339.81$277.79RVU18D
2018-07-01$3,339.81$277.79RVU18C
2018-04-01$3,339.81$277.79RVU18B
2018-01-01$3,339.81$277.79RVU18AR1
2017-10-01$3,286.14$277.59RVU17D
2017-07-01$3,286.14$277.59RVU17C
2017-04-01$3,286.14$277.59RVU17B
2017-01-01$3,286.14$277.59RVU17A
2016-10-01$3,331.70$282.64RVU16D
2016-07-01$3,331.70$282.64RVU16C
2016-04-01$3,331.70$282.64RVU16B
2016-01-01$3,331.70$282.64RVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 45388 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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
RVUs for 45388PPRRVU2026_Oct_nonQPP.csv, line 5,522 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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