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CMS RVU26D · Effective 2026-10-01

45338 in Delaware

Office / nonfacility

$331.38

Base rate per service

Facility setting

$107.97

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Endoscopy

About 45338: Flexible sigmoidoscopy with snare removal

Report this service when a clinician uses a flexible sigmoidoscope to remove a polyp or other lesion in the distal colon with a snare.

A clinician advances a flexible scope through the rectum to examine the distal colon and uses a snare to remove a lesion, such as a polyp found in the sigmoid colon. Gastroenterologists and colorectal surgeons commonly perform the procedure in an endoscopy unit or hospital outpatient department. The removed tissue may be submitted for pathologic examination. This code reflects snare removal, not a procedure limited to inspecting the bowel or sampling tissue with biopsy forceps.

Report the service when the procedure record supports flexible sigmoidoscopy and snare removal; document the lesion site and removal technique. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 45338

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Endoscopy family pricing applies when related endoscopies are performed together.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.00 · 20%
  • Practice expense (office) RVU7.78 · 78%
  • Malpractice RVU0.25 · 2%

6.6K

Medicare services in 2024 · #1692 by national volume

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.

45338 compared with similar codes

Office rates for Delaware, from the same CMS release.

45333

Flexible sigmoidoscopy

Hot biopsy forceps removal

$363.86

Choose 45338 when a snare removes the lesion. Choose 45333 when removal is performed with hot biopsy forceps or bipolar cautery.

45331

Sigmoidoscopy

With biopsy

$319.32

45331 represents biopsy during flexible sigmoidoscopy; 45338 represents removal with a snare.

45330

Flexible sigmoidoscopy

Diagnostic

$212.63

45330 is diagnostic flexible sigmoidoscopy without lesion removal. Use 45338 when the examination includes snare removal.

45308

Lesion removal

Rigid scope, cautery technique

$224.08

Both involve snare removal, but 45308 is for proctosigmoidoscopy; 45338 is for flexible sigmoidoscopy.

The same code, a different location

How does Delaware compare?

45338 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $331.38

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $382.50

    $51.12 higher than Delaware

  3. Dc + Md/Va Suburbs

    $385.82

    $54.44 higher than Delaware

  4. Miami

    $358.43

    $27.05 higher than Delaware

  5. Chicago

    $347.59

    $16.21 higher than Delaware

  6. Manhattan

    $386.28

    $54.90 higher than Delaware

  7. Alaska*

    $381.55

    $50.17 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 45338 ranges from $294.32 in Arkansas to $453.34 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 45338

    Office

    $298.90

    Facility

    $101.05

    $32.48 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 45338

    Office

    $294.32

    Facility

    $100.08

    $37.06 lower than Delaware for the office setting.

  • Arizona

    Arizona · 45338

    Office

    $325.75

    Facility

    $106.64

    $5.63 lower than Delaware for the office setting.

  • Bakersfield

    California · 45338

    Office

    $357.96

    Facility

    $110.13

    $26.58 higher than Delaware for the office setting.

  • Chico

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • El Centro

    California · 45338

    Office

    $357.26

    Facility

    $109.43

    $25.88 higher than Delaware for the office setting.

  • Fresno

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Madera

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Merced

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Modesto

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Napa

    California · 45338

    Office

    $417.75

    Facility

    $119.71

    $86.37 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45338

    Office

    $381.03

    Facility

    $113.75

    $49.65 higher than Delaware for the office setting.

  • Redding

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Rest Of California

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45338

    Office

    $359.93

    Facility

    $112.10

    $28.55 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45338

    Office

    $375.90

    Facility

    $112.92

    $44.52 higher than Delaware for the office setting.

  • Salinas

    California · 45338

    Office

    $374.52

    Facility

    $112.45

    $43.14 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45338

    Office

    $384.12

    Facility

    $113.68

    $52.74 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45338

    Office

    $443.38

    Facility

    $124.55

    $112.00 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 45338

    Office

    $443.10

    Facility

    $124.26

    $111.72 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 45338

    Office

    $453.34

    Facility

    $127.27

    $121.96 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 45338

    Office

    $452.18

    Facility

    $126.11

    $120.80 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45338

    Office

    $368.39

    Facility

    $110.84

    $37.01 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 45338

    Office

    $388.41

    Facility

    $113.67

    $57.03 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 45338

    Office

    $376.14

    Facility

    $112.48

    $44.76 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 45338

    Office

    $392.39

    Facility

    $114.71

    $61.01 higher than Delaware for the office setting.

  • Stockton

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Vallejo

    California · 45338

    Office

    $417.34

    Facility

    $119.31

    $85.96 higher than Delaware for the office setting.

  • Visalia

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Yuba City

    California · 45338

    Office

    $357.22

    Facility

    $109.39

    $25.84 higher than Delaware for the office setting.

  • Colorado

    Colorado · 45338

    Office

    $350.61

    Facility

    $110.02

    $19.23 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 45338

    Office

    $358.11

    Facility

    $114.57

    $26.73 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 45338

    Office

    $345.14

    Facility

    $116.07

    $13.76 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 45338

    Office

    $327.78

    Facility

    $111.60

    $3.60 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 45338

    Office

    $341.05

    Facility

    $111.31

    $9.67 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 45338

    Office

    $308.55

    Facility

    $106.85

    $22.83 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 45338

    Office

    $367.10

    Facility

    $109.99

    $35.72 higher than Delaware for the office setting.

  • Iowa

    Iowa · 45338

    Office

    $307.89

    Facility

    $100.98

    $23.49 lower than Delaware for the office setting.

  • Idaho

    Idaho · 45338

    Office

    $309.82

    Facility

    $101.79

    $21.56 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 45338

    Office

    $322.69

    Facility

    $114.66

    $8.69 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 45338

    Office

    $317.10

    Facility

    $110.65

    $14.28 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 45338

    Office

    $348.94

    Facility

    $116.71

    $17.56 higher than Delaware for the office setting.

  • Indiana

    Indiana · 45338

    Office

    $311.75

    Facility

    $102.13

    $19.63 lower than Delaware for the office setting.

  • Kansas

    Kansas · 45338

    Office

    $305.92

    Facility

    $101.51

    $25.46 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 45338

    Office

    $305.46

    Facility

    $104.43

    $25.92 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 45338

    Office

    $320.81

    Facility

    $108.03

    $10.57 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 45338

    Office

    $304.78

    Facility

    $104.66

    $26.60 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 45338

    Office

    $387.24

    Facility

    $117.25

    $55.86 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45338

    Office

    $348.16

    Facility

    $110.05

    $16.78 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45338

    Office

    $357.03

    Facility

    $114.40

    $25.65 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 45338

    Office

    $338.11

    Facility

    $109.28

    $6.73 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 45338

    Office

    $311.07

    Facility

    $103.03

    $20.31 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 45338

    Office

    $329.59

    Facility

    $105.50

    $1.79 lower than Delaware for the office setting.

  • Detroit

    Michigan · 45338

    Office

    $331.64

    Facility

    $113.43

    $0.26 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 45338

    Office

    $313.48

    Facility

    $107.03

    $17.90 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 45338

    Office

    $336.67

    Facility

    $103.99

    $5.29 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 45338

    Office

    $318.97

    Facility

    $106.64

    $12.41 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 45338

    Office

    $322.55

    Facility

    $107.28

    $8.83 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 45338

    Office

    $298.93

    Facility

    $104.01

    $32.45 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 45338

    Office

    $296.71

    Facility

    $102.02

    $34.67 lower than Delaware for the office setting.

  • Montana**

    Montana · 45338

    Office

    $334.99

    Facility

    $108.87

    $3.61 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 45338

    Office

    $314.59

    Facility

    $103.61

    $16.79 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 45338

    Office

    $330.05

    Facility

    $103.93

    $1.33 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 45338

    Office

    $309.81

    Facility

    $101.10

    $21.57 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 45338

    Office

    $344.62

    Facility

    $109.23

    $13.24 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 45338

    Office

    $381.36

    Facility

    $119.06

    $49.98 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 45338

    Office

    $362.40

    Facility

    $115.47

    $31.02 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 45338

    Office

    $315.12

    Facility

    $107.77

    $16.26 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 45338

    Office

    $333.88

    Facility

    $107.53

    $2.50 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45338

    Office

    $395.56

    Facility

    $126.69

    $64.18 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45338

    Office

    $364.46

    Facility

    $116.85

    $33.08 higher than Delaware for the office setting.

  • Queens

    New York · 45338

    Office

    $390.27

    Facility

    $122.99

    $58.89 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 45338

    Office

    $319.54

    Facility

    $104.72

    $11.84 lower than Delaware for the office setting.

  • Ohio

    Ohio · 45338

    Office

    $312.47

    Facility

    $106.02

    $18.91 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 45338

    Office

    $305.34

    Facility

    $103.42

    $26.04 lower than Delaware for the office setting.

  • Portland

    Oregon · 45338

    Office

    $362.79

    Facility

    $111.56

    $31.41 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 45338

    Office

    $331.49

    Facility

    $106.27

    $0.11 higher than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45338

    Office

    $348.48

    Facility

    $113.08

    $17.10 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45338

    Office

    $313.24

    Facility

    $105.66

    $18.14 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 45338

    Office

    $337.74

    Facility

    $109.13

    $6.36 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 45338

    Office

    $343.95

    Facility

    $110.37

    $12.57 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 45338

    Office

    $314.01

    Facility

    $105.07

    $17.37 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 45338

    Office

    $329.47

    Facility

    $103.34

    $1.91 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 45338

    Office

    $307.50

    Facility

    $101.95

    $23.88 lower than Delaware for the office setting.

  • Austin

    Texas · 45338

    Office

    $349.26

    Facility

    $110.03

    $17.88 higher than Delaware for the office setting.

  • Beaumont

    Texas · 45338

    Office

    $311.03

    Facility

    $105.26

    $20.35 lower than Delaware for the office setting.

  • Brazoria

    Texas · 45338

    Office

    $331.37

    Facility

    $107.28

    $0.01 lower than Delaware for the office setting.

  • Dallas

    Texas · 45338

    Office

    $333.39

    Facility

    $108.17

    $2.01 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 45338

    Office

    $330.90

    Facility

    $107.94

    $0.48 lower than Delaware for the office setting.

  • Galveston

    Texas · 45338

    Office

    $332.29

    Facility

    $107.75

    $0.91 higher than Delaware for the office setting.

  • Houston

    Texas · 45338

    Office

    $336.87

    Facility

    $112.32

    $5.49 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 45338

    Office

    $320.95

    Facility

    $106.36

    $10.43 lower than Delaware for the office setting.

  • Utah

    Utah · 45338

    Office

    $318.57

    Facility

    $106.01

    $12.81 lower than Delaware for the office setting.

  • Virginia

    Virginia · 45338

    Office

    $328.14

    Facility

    $105.86

    $3.24 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45338

    Office

    $337.74

    Facility

    $109.13

    $6.36 higher than Delaware for the office setting.

  • Vermont

    Vermont · 45338

    Office

    $328.29

    Facility

    $104.42

    $3.09 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 45338

    Office

    $347.66

    Facility

    $109.55

    $16.28 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 45338

    Office

    $395.81

    Facility

    $118.36

    $64.43 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 45338

    Office

    $318.32

    Facility

    $101.69

    $13.06 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 45338

    Office

    $304.57

    Facility

    $108.07

    $26.81 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 45338

    Office

    $332.84

    Facility

    $106.72

    $1.46 higher than Delaware for the office setting.

See how rates vary across the country

45338 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$294.32

$405.28

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$381.551
AL$298.901
AR$294.321
AZ$325.751
CA$357.22–$453.3429
CO$350.611
CT$358.111
DC$385.821
DE$331.381
FL$327.78–$358.433
GA$308.55–$341.052
GU$367.101
HI$367.101
IA$307.891
ID$309.821
IL$317.10–$348.944
IN$311.751
KS$305.921
KY$305.461
LA$304.78–$320.812
MA$348.16–$387.242
MD$338.11–$385.823
ME$311.07–$329.592
MI$313.48–$331.642
MN$336.671
MO$298.93–$322.553
MS$296.711
MT$334.991
NC$314.591
ND$330.051
NE$309.811
NH$344.621
NJ$362.40–$381.362
NM$315.121
NV$333.881
NY$319.54–$395.565
OH$312.471
OK$305.341
OR$331.49–$362.792
PA$313.24–$348.482
PR$337.741
RI$343.951
SC$314.011
SD$329.471
TN$307.501
TX$311.03–$349.268
UT$318.571
VA$328.14–$385.822
VI$337.741
VT$328.291
WA$347.66–$395.812
WI$318.321
WV$304.571
WY$332.841

Explore 45338 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 45338 in Delaware, the physician’s office rate is $331.38 and the facility-setting rate is $107.97: a difference of $223.41.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 45338 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$364.52

$331.38 × 110% = $364.52

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 45338 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

5,505

Code
45338
Physician work
2.00
Practice expense
7.78
Malpractice
0.25

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 45338 in Delaware
ComponentRVULocality factorAdjusted
Physician work2.00× 1.0052.0100
Practice expense7.78× 0.9887.6866
Malpractice0.25× 0.8990.2248
Total RVUs9.9214
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$331.38

Open 45338 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work21.005
Practice expense7.780.988
Malpractice0.250.899

(2 × 1.005 + 7.78 × 0.988 + 0.25 × 0.899) × $33.4009 = $331.38

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work21.005
Practice expense1.010.988
Malpractice0.250.899

(2 × 1.005 + 1.01 × 0.988 + 0.25 × 0.899) × $33.4009 = $107.97

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

45338 · Office / nonfacility

$331.38

Effective 2026-10-01

The base rate is $46.33 higher than on 2025-10-01, moving from $285.05 to $331.38 (16.3%).

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

    $285.05changed to$331.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.05 changed to 2.00
    • Practice expense RVU 6.54 changed to 7.78
    • Malpractice RVU 0.27 changed to 0.25
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $285.05

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$331.38$107.97RVU26D
2026-07-01$331.38$107.97RVU26C
2026-04-01$331.38$107.97RVU26B
2026-01-01$331.38$107.97RVU26A
2025-10-01$285.05$115.63RVU25D
2025-07-01$285.05$115.63RVU25C
2025-04-01$285.05$115.63RVU25B
2025-01-01$285.05$115.63RVU25A

45338 billing questions

How is this different from 45333?

Use 45338 for snare removal. Code 45333 describes removal using hot biopsy forceps or bipolar cautery.

Can this be reported for a biopsy alone?

No. A biopsy without snare removal is represented by the biopsy service, such as 45331.

Should the code be billed once for each polyp?

The service is the snare-removal procedure, not a per-polyp unit. Document the lesions treated and the technique used.

What happens when another related endoscopy is performed in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together; payment is not treated as unrelated procedures.

Is modifier 50 appropriate, or can an assistant be paid?

Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this code.

What does the 0-day global period include?

Same-day preoperative and postoperative care is included in the procedure's global period.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 45338PPRRVU2026_Oct_nonQPP.csv, line 5,505 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet