CPT code 45390: Colonoscopy, mucosal lesion resection2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $290.72 for 45390 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 45390 nationwide

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

What 45390 covers

A gastroenterologist or colorectal surgeon uses a flexible colonoscope to inspect the colon and remove a mucosal lesion by endoscopic mucosal resection (EMR). EMR commonly involves lifting the target from the underlying tissue and resecting it endoscopically, often with a snare. It is used for colorectal lesions, including flat or sessile lesions, in hospital outpatient departments and ambulatory surgery centers.

Report the service when the documented therapeutic technique is EMR, not simply biopsy, forceps removal, or conventional snare removal. The procedure note should identify the lesion’s location and characteristics and describe the resection technique and findings. 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 claim because of a statutory restriction, and co-surgeon and team-surgery reporting 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 Puerto Rico compares for 45390

Across 109 of 109 payment localities, the facility rate for 45390 runs from $269.60 in Arkansas to $383.54 in Alaska. Puerto Rico pays $290.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

45390 rates by state

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

See 45390 in every payment locality

How the 45390 rate is calculated

Each of 45390’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 45390

The CMS indicators that decide how 45390 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 45390

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

How 45390 has changed in Puerto Rico

Price 45390 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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