CPT code 45392: Colonoscopy with EUS, with needle sampling2026 Medicare rate & RVUs in Virgin Islands, VI
Reports colonoscopy with endoscopic ultrasound-guided needle aspiration or biopsy to sample a lesion within or beyond the bowel wall.
In Virgin Islands, VI, 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.
On this page 11 sections
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 Virgin Islands, VI 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. Virgin Islands, VI pays $266.30. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virgin Islands, VI · this page$266.30
- Los Angeles, CA · California$278.53+$12.23
- Washington, DC area · District of Columbia$289.67+$23.37
- Miami, FL · Florida$299.75+$33.45
- Chicago, IL · Illinois$293.84+$27.54
- Manhattan, NY · New York$300.04+$33.74
- Alaska · Alaska$350.56+$84.26
Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $248.72 |
| ArkansasArkansas | — | $246.62 |
| ArizonaArizona | — | $260.88 |
| Bakersfield, CACalifornia | — | $267.69 |
| Chico, CACalifornia | — | $265.84 |
| El Centro, CACalifornia | — | $265.94 |
| Fresno, CACalifornia | — | $265.84 |
| Hanford, CACalifornia | — | $265.84 |
| Madera, CACalifornia | — | $265.84 |
| Merced, CACalifornia | — | $265.84 |
| Modesto, CACalifornia | — | $265.84 |
| Napa, CACalifornia | — | $288.26 |
| Oxnard, CACalifornia | — | $275.30 |
| Redding, CACalifornia | — | $265.84 |
| Rest of CaliforniaCalifornia | — | $265.84 |
| Riverside, CACalifornia | — | $272.48 |
| Sacramento, CACalifornia | — | $273.70 |
| Salinas, CACalifornia | — | $272.54 |
| San Diego, CACalifornia | — | $274.94 |
| Marin County, CACalifornia | — | $299.11 |
| San Francisco, CACalifornia | — | $298.42 |
| San Benito County, CACalifornia | — | $305.49 |
| Santa Clara County, CACalifornia | — | $302.66 |
| San Luis Obispo, CACalifornia | — | $268.70 |
| Santa Cruz, CACalifornia | — | $274.47 |
| Santa Maria, CACalifornia | — | $272.46 |
| Santa Rosa, CACalifornia | — | $276.94 |
| Stockton, CACalifornia | — | $265.84 |
| Vallejo, CACalifornia | — | $287.26 |
| Visalia, CACalifornia | — | $265.84 |
| Yuba City, CACalifornia | — | $265.84 |
| ColoradoColorado | — | $267.81 |
| ConnecticutConnecticut | — | $278.85 |
| DelawareDelaware | — | $263.91 |
| Fort Lauderdale, FLFlorida | — | $283.20 |
| Rest of FloridaFlorida | — | $273.19 |
| Atlanta, GAGeorgia | — | $271.57 |
| Rest of GeorgiaGeorgia | — | $262.60 |
| Hawaii, Guam, HIHawaii | — | $266.40 |
| IowaIowa | — | $247.94 |
| IdahoIdaho | — | $249.82 |
| East St. Louis, ILIllinois | — | $281.21 |
| Rest of IllinoisIllinois | — | $271.56 |
| Suburban Chicago, ILIllinois | — | $284.65 |
| IndianaIndiana | — | $250.55 |
| KansasKansas | — | $249.38 |
| KentuckyKentucky | — | $256.76 |
| New Orleans, LALouisiana | — | $264.72 |
| Rest of LouisianaLouisiana | — | $257.37 |
| Metropolitan Boston, MAMassachusetts | — | $283.86 |
| Rest of MassachusettsMassachusetts | — | $268.12 |
| Baltimore area, MDMaryland | — | $278.42 |
| Rest of MarylandMaryland | — | $266.79 |
| Rest of MaineMaine | — | $252.85 |
| Southern Maine, MEMaine | — | $257.75 |
| Detroit, MIMichigan | — | $277.52 |
| Rest of MichiganMichigan | — | $262.72 |
| MinnesotaMinnesota | — | $253.46 |
| Metropolitan Kansas City, MOMissouri | — | $261.35 |
| Metropolitan St. Louis, MOMissouri | — | $262.72 |
| Rest of MissouriMissouri | — | $256.17 |
| MississippiMississippi | — | $251.31 |
| MontanaMontana | — | $265.83 |
| North CarolinaNorth Carolina | — | $254.06 |
| North DakotaNorth Dakota | — | $253.77 |
| NebraskaNebraska | — | $248.08 |
| New HampshireNew Hampshire | — | $266.05 |
| Northern New JerseyNew Jersey | — | $289.17 |
| Rest of New JerseyNew Jersey | — | $281.12 |
| New MexicoNew Mexico | — | $264.45 |
| NevadaNevada | — | $262.54 |
| NYC suburbs and Long Island, NYNew York | — | $307.35 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $284.52 |
| Queens, NYNew York | — | $298.43 |
| Rest of New YorkNew York | — | $256.50 |
| OhioOhio | — | $260.25 |
| OklahomaOklahoma | — | $254.22 |
| Portland, OROregon | — | $270.90 |
| Rest of OregonOregon | — | $259.55 |
| Metropolitan Philadelphia, PAPennsylvania | — | $275.75 |
| Rest of PennsylvaniaPennsylvania | — | $259.30 |
| Puerto RicoPuerto Rico | — | $266.30 |
| Rhode IslandRhode Island | — | $269.27 |
| South CarolinaSouth Carolina | — | $257.76 |
| South DakotaSouth Dakota | — | $252.34 |
| TennesseeTennessee | — | $250.39 |
| Austin, TXTexas | — | $267.76 |
| Beaumont, TXTexas | — | $258.44 |
| Brazoria, TXTexas | — | $262.22 |
| Dallas, TXTexas | — | $264.32 |
| Fort Worth, TXTexas | — | $263.92 |
| Galveston, TXTexas | — | $263.33 |
| Houston, TXTexas | — | $274.50 |
| Rest of TexasTexas | — | $260.50 |
| UtahUtah | — | $259.80 |
| VirginiaVirginia | — | $258.75 |
| VermontVermont | — | $255.14 |
| Rest of WashingtonWashington | — | $266.85 |
| King County, WAWashington | — | $286.18 |
| WisconsinWisconsin | — | $248.98 |
| West VirginiaWest Virginia | — | $265.95 |
| WyomingWyoming | — | $260.57 |
45392 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 45392
RVUs × geographic indexes × conversion factor
Work5.36
5.36 RVUs× 1.000 GPCI
Practice expense1.99
1.99 RVUs× 1.000 GPCI
Malpractice0.61
0.61 RVUs× 1.000 GPCI
Adjusted RVUs
7.9600
Conversion factor
$33.4009
Medicare rate
$265.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virgin Islands, VI inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,526
- Code
- 45392
- Physician work
- 5.36
- Practice expense
- 1.99
- Malpractice
- 0.61
GPCI2026.csv
107
- Locality
- Virgin Islands, VI
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.36 | × 1.000 | 5.3600 |
| Practice expense | 1.99 | × 1.011 | 2.0119 |
| Malpractice | 0.61 | × 0.985 | 0.6008 |
| Total RVUs | 7.9727 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Virgin Islands, VI$266.30
Facility: (5.36 × 1 + 1.99 × 1.011 + 0.61 × 0.985) × $33.4009 = $266.30
Payment rules and modifiers for 45392
The CMS indicators that decide how 45392 is paid alongside other services.
CMS payment indicators · 45392
Colonoscopy with EUS, with needle sampling
| 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
45392 without 51 · national facility
$265.87
Colonoscopy with EUS, with needle sampling
45392-51 · Second procedure: 50%
$132.94
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 45392 has changed in Virgin Islands, VI
45392 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $266.30 | RVU26D |
| 2026-07-01 | Not available in this setting | $266.30 | RVU26C |
| 2026-04-01 | Not available in this setting | $266.30 | RVU26B |
| 2026-01-01 | Not available in this setting | $266.30 | RVU26A |
| 2025-10-01 | Not available in this setting | $290.42 | RVU25D |
| 2025-07-01 | Not available in this setting | $290.42 | RVU25C |
| 2025-04-01 | Not available in this setting | $290.42 | RVU25B |
| 2025-01-01 | Not available in this setting | $290.42 | RVU25A |
| 2024-10-01 | Not available in this setting | $298.51 | RVU24D |
| 2024-07-01 | Not available in this setting | $298.51 | RVU24C |
| 2024-04-01 | Not available in this setting | $298.51 | RVU24B |
| 2024-03-09 | Not available in this setting | $298.51 | RVU24AR |
| 2024-01-01 | Not available in this setting | $293.64 | RVU24A |
| 2023-10-01 | Not available in this setting | $302.67 | RVU23D |
| 2023-07-01 | Not available in this setting | $302.27 | RVU23C |
| 2023-04-01 | Not available in this setting | $302.27 | RVU23B |
| 2023-01-01 | Not available in this setting | $302.27 | RVU23A |
| 2022-10-01 | Not available in this setting | $307.77 | RVU22D |
| 2022-07-01 | Not available in this setting | $307.77 | RVU22C |
| 2022-04-01 | Not available in this setting | $307.77 | RVU22B |
| 2022-01-01 | Not available in this setting | $307.77 | RVU22A |
| 2021-10-01 | Not available in this setting | $309.96 | RVU21D |
| 2021-07-01 | Not available in this setting | $309.96 | RVU21C |
| 2021-04-01 | Not available in this setting | $309.96 | RVU21B |
| 2021-01-01 | Not available in this setting | $309.96 | RVU21A |
| 2020-10-01 | Not available in this setting | $317.38 | RVU20D |
| 2020-07-01 | Not available in this setting | $317.38 | RVU20C |
| 2020-04-01 | Not available in this setting | $317.38 | RVU20B |
| 2020-01-01 | Not available in this setting | $317.38 | RVU20A |
| 2019-10-01 | Not available in this setting | $321.54 | RVU19D |
| 2019-07-01 | Not available in this setting | $321.54 | RVU19C |
| 2019-04-01 | Not available in this setting | $321.54 | RVU19B |
| 2019-01-01 | Not available in this setting | $321.54 | RVU19A |
| 2018-10-01 | Not available in this setting | $322.63 | RVU18D |
| 2018-07-01 | Not available in this setting | $322.63 | RVU18C |
| 2018-04-01 | Not available in this setting | $322.63 | RVU18B |
| 2018-01-01 | Not available in this setting | $322.63 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $321.25 | RVU17D |
| 2017-07-01 | Not available in this setting | $321.25 | RVU17C |
| 2017-04-01 | Not available in this setting | $321.25 | RVU17B |
| 2017-01-01 | Not available in this setting | $321.25 | RVU17A |
| 2016-10-01 | Not available in this setting | $321.76 | RVU16D |
| 2016-07-01 | Not available in this setting | $321.76 | RVU16C |
| 2016-04-01 | Not available in this setting | $321.76 | RVU16B |
| 2016-01-01 | Not available in this setting | $321.76 | RVU16A |
| 2015-10-01 | Not available in this setting | $380.76 | RVU15D |
| 2015-07-01 | Not available in this setting | $380.76 | RVU15C |
| 2015-04-01 | Not available in this setting | $378.87 | RVU15B |
| 2015-01-01 | Not available in this setting | $378.87 | RVU15A |
| 2014-10-01 | Not available in this setting | $388.18 | RVU14D |
| 2014-07-01 | Not available in this setting | $388.18 | RVU14C |
| 2014-04-01 | Not available in this setting | $388.18 | RVU14B |
| 2014-01-01 | Not available in this setting | $388.18 | RVU14A |
| 2013-10-01 | Not available in this setting | $385.06 | RVU13D |
| 2013-07-01 | Not available in this setting | $385.06 | RVU13C |
| 2013-04-01 | Not available in this setting | $385.06 | RVU13B |
| 2013-01-01 | Not available in this setting | $385.06 | RVU13AR |
Where the Virgin Islands, VI rate applies
Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.
- Charlotte Amalie
- Charlotte Amalie East
- Charlotte Amalie West
- Christiansted
- Coral Bay
- Cruz Bay
- Frederiksted
- Frederiksted Southeast
45392 billing questions
How does this differ from 45391?
45392 includes EUS-guided fine needle aspiration or biopsy. Use 45391 for colonoscopy with EUS when needle sampling is not performed.
Can 45380 also be reported for the needle specimen?
The EUS-guided needle sampling is part of 45392, not a separate forceps biopsy. A separately performed mucosal biopsy is a different service and should be supported by distinct documentation.
What documentation supports 45392?
Document the endoscopic ultrasound findings, the target's location, needle guidance, sampling performed, and the specimen obtained. The record should distinguish needle sampling from a surface biopsy.
How are related endoscopies paid when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together, so payment follows the family pricing rules rather than treating every related procedure as an independent full service.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for it under the statutory restriction.
Can co-surgeons or a surgical team report this service?
Co-surgeons and team surgery are not permitted for this code under the CMS rules.
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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