CPT code 45392: Colonoscopy with EUS, with needle sampling2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $266.30 for 45392 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 45392 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 45392 covers

A gastroenterologist advances a colonoscope and uses endoscopic ultrasound to identify a target in or near the colorectal wall, then guides a needle through the endoscope to obtain a sample. Typical targets include subepithelial lesions or nearby structures such as perirectal lymph nodes. The service may be performed in a hospital or ambulatory endoscopy center, with the needle specimen sent for pathology or cytology review.

Report this code when the colonoscopic EUS examination includes ultrasound-guided intramural or transmural fine needle aspiration or biopsy; documentation should identify the target, ultrasound guidance, needle sampling, and specimen obtained. It is distinct from EUS without needle sampling and from forceps biopsy of the mucosal surface. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing governs payment. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery under the statutory restriction; 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 Puerto Rico compares for 45392

Across 109 of 109 payment localities, the facility rate for 45392 runs from $246.62 in Arkansas to $350.56 in Alaska. Puerto Rico pays $266.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

45392 rates by state

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

See 45392 in every payment locality

How the 45392 rate is calculated

Each of 45392’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 45392

The CMS indicators that decide how 45392 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 45392

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

How 45392 has changed in Puerto Rico

Price 45392 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