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CMS RVU26D · Effective 2026-10-01

45385 in Madera

Office / nonfacility

$526.70

Base rate per service

Facility setting

$223.60

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.

GI endoscopy

About 45385: Colonoscopy with snare removal of polyps or lesions

Report 45385 when one or more polyps or other lesions are removed during flexible colonoscopy with a wire snare, with or without cautery.

During this procedure, a gastroenterologist or colorectal surgeon advances a flexible colonoscope through the colon, typically to the cecum. Polyps or other lesions are captured with a wire snare and removed either cold or with electrocautery. Removed tissue is typically submitted for pathology. Most cases occur in hospital outpatient departments and ambulatory surgery centers, with a smaller share in office endoscopy suites. Common situations include screening colonoscopies that uncover adenomas, surveillance after prior polyps, and evaluation of a positive stool test.

Report one unit per session regardless of how many lesions are snared. The procedure report should identify the removal technique, lesion sites and sizes, exam extent, and bowel prep quality. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing uses diagnostic colonoscopy 45378 as the base to calculate payment for additional procedures. Medicare does not pay an assistant at surgery for 45385; co-surgeons and team surgery are not permitted. Because the colon is not a bilateral structure, modifier 50 is inappropriate.

CMS billing rules for 45385

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 RVU4.46 · 30%
  • Practice expense (office) RVU10.00 · 67%
  • Malpractice RVU0.51 · 3%

1.6M

Medicare services in 2024 · #99 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.

45385 compared with similar codes

Office rates for Madera, from the same CMS release.

45384

Colonoscopy polyp removal

Hot biopsy or bipolar cautery

$569.32

45384 covers lesion removal with hot biopsy forceps or bipolar cautery. Use 45385 when a snare removes the lesion, whether the snare is hot or cold.

45380

Colonoscopy with biopsy

Single or multiple forceps biopsies

$509.04

45380 covers biopsy, including cold forceps removal of a small polyp. Use 45385 when a snare removes the lesion; do not report both for the same lesion.

45390

Colonoscopy

Mucosal lesion resection

No office rate

45390 applies when documentation supports endoscopic mucosal resection. Injection before snaring, by itself, does not establish that technique; use 45385 for conventional snare removal.

45378

Colonoscopy

Diagnostic, no tissue removal

$398.34

45378 covers diagnostic colonoscopy without lesion removal. When a lesion is removed by snare, report 45385 instead of separately reporting the diagnostic exam.

The same code, a different location

How does Madera compare?

In Bakersfield, the office rate for 45385 is $528.25—$1.55 higher than the $526.70 rate in Madera. Both use the same code, release and participation basis.

45385 across payment areas

Same release and payment basis · bars start at $0

  1. Madera · This locality

    $526.70

  2. Bakersfield

    $528.25

    $1.55 higher than Madera

  3. Chico

    $526.70

    The same base rate than Madera

  4. El Centro

    $526.79

    $0.09 higher than Madera

  5. Fresno

    $526.70

    The same base rate than Madera

  6. Hanford-Corcoran

    $526.70

    The same base rate than Madera

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

    $561.52

    $34.82 higher than Madera

Other payment areas listed in California 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, 45385 ranges from $444.65 in Arkansas to $656.13 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

  • Merced

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Modesto

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Napa

    California · 45385

    Office

    $607.23

    Facility

    $242.73

    $80.53 higher than Madera for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45385

    Office

    $558.55

    Facility

    $231.66

    $31.85 higher than Madera for the office setting.

  • Redding

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Rest Of California

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45385

    Office

    $532.25

    Facility

    $229.14

    $5.55 higher than Madera for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45385

    Office

    $551.91

    Facility

    $230.28

    $25.21 higher than Madera for the office setting.

  • Salinas

    California · 45385

    Office

    $549.83

    Facility

    $229.30

    $23.13 higher than Madera for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45385

    Office

    $562.14

    Facility

    $231.38

    $35.44 higher than Madera for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45385

    Office

    $641.89

    Facility

    $251.94

    $115.19 higher than Madera for the office setting.

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

    California · 45385

    Office

    $641.31

    Facility

    $251.36

    $114.61 higher than Madera for the office setting.

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

    California · 45385

    Office

    $656.13

    Facility

    $257.33

    $129.43 higher than Madera for the office setting.

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

    California · 45385

    Office

    $653.76

    Facility

    $254.96

    $127.06 higher than Madera for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45385

    Office

    $541.07

    Facility

    $226.07

    $14.37 higher than Madera for the office setting.

  • Santa Cruz-Watsonville

    California · 45385

    Office

    $567.05

    Facility

    $231.03

    $40.35 higher than Madera for the office setting.

  • Santa Maria-Santa Barbara

    California · 45385

    Office

    $551.72

    Facility

    $229.26

    $25.02 higher than Madera for the office setting.

  • Santa Rosa-Petaluma

    California · 45385

    Office

    $572.73

    Facility

    $233.12

    $46.03 higher than Madera for the office setting.

  • Stockton

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Vallejo

    California · 45385

    Office

    $606.40

    Facility

    $241.89

    $79.70 higher than Madera for the office setting.

  • Visalia

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Yuba City

    California · 45385

    Office

    $526.70

    Facility

    $223.60

    The same base rate than Madera for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45385

    Office

    $569.43

    Facility

    $243.65

    $42.73 higher than Madera for the office setting.

  • Miami

    Florida · 45385

    Office

    $539.75

    Facility

    $251.85

    $13.05 higher than Madera for the office setting.

  • Chicago

    Illinois · 45385

    Office

    $524.78

    Facility

    $246.84

    $1.92 lower than Madera for the office setting.

  • Manhattan

    New York · 45385

    Office

    $573.64

    Facility

    $252.27

    $46.94 higher than Madera for the office setting.

  • Alaska*

    Alaska · 45385

    Office

    $588.56

    Facility

    $294.02

    $61.86 higher than Madera for the office setting.

  • Alabama

    Alabama · 45385

    Office

    $450.87

    Facility

    $208.88

    $75.83 lower than Madera for the office setting.

  • Arkansas

    Arkansas · 45385

    Office

    $444.65

    Facility

    $207.09

    $82.05 lower than Madera for the office setting.

  • Arizona

    Arizona · 45385

    Office

    $487.20

    Facility

    $219.22

    $39.50 lower than Madera for the office setting.

  • Colorado

    Colorado · 45385

    Office

    $519.45

    Facility

    $225.19

    $7.25 lower than Madera for the office setting.

  • Connecticut

    Connecticut · 45385

    Office

    $532.29

    Facility

    $234.43

    $5.59 higher than Madera for the office setting.

  • Delaware

    Delaware · 45385

    Office

    $495.03

    Facility

    $221.79

    $31.67 lower than Madera for the office setting.

  • Fort Lauderdale

    Florida · 45385

    Office

    $518.12

    Facility

    $237.96

    $8.58 lower than Madera for the office setting.

  • Rest Of Florida

    Florida · 45385

    Office

    $493.88

    Facility

    $229.49

    $32.82 lower than Madera for the office setting.

  • Atlanta

    Georgia · 45385

    Office

    $509.23

    Facility

    $228.24

    $17.47 lower than Madera for the office setting.

  • Rest Of Georgia

    Georgia · 45385

    Office

    $467.21

    Facility

    $220.52

    $59.49 lower than Madera for the office setting.

  • Hawaii, Guam

    Hawaii · 45385

    Office

    $538.60

    Facility

    $224.15

    $11.90 higher than Madera for the office setting.

  • Iowa

    Iowa · 45385

    Office

    $461.35

    Facility

    $208.30

    $65.35 lower than Madera for the office setting.

  • Idaho

    Idaho · 45385

    Office

    $464.31

    Facility

    $209.88

    $62.39 lower than Madera for the office setting.

  • East St. Louis

    Illinois · 45385

    Office

    $490.56

    Facility

    $236.13

    $36.14 lower than Madera for the office setting.

  • Rest Of Illinois

    Illinois · 45385

    Office

    $480.54

    Facility

    $228.04

    $46.16 lower than Madera for the office setting.

  • Suburban Chicago

    Illinois · 45385

    Office

    $523.22

    Facility

    $239.20

    $3.48 lower than Madera for the office setting.

  • Indiana

    Indiana · 45385

    Office

    $466.87

    Facility

    $210.50

    $59.83 lower than Madera for the office setting.

  • Kansas

    Kansas · 45385

    Office

    $459.50

    Facility

    $209.49

    $67.20 lower than Madera for the office setting.

  • Kentucky

    Kentucky · 45385

    Office

    $461.49

    Facility

    $215.63

    $65.21 lower than Madera for the office setting.

  • New Orleans

    Louisiana · 45385

    Office

    $482.62

    Facility

    $222.38

    $44.08 lower than Madera for the office setting.

  • Rest Of Louisiana

    Louisiana · 45385

    Office

    $460.88

    Facility

    $216.13

    $65.82 lower than Madera for the office setting.

  • Metropolitan Boston

    Massachusetts · 45385

    Office

    $569.04

    Facility

    $238.83

    $42.34 higher than Madera for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45385

    Office

    $516.64

    Facility

    $225.42

    $10.06 lower than Madera for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45385

    Office

    $530.81

    Facility

    $234.07

    $4.11 higher than Madera for the office setting.

  • Rest Of Maryland

    Maryland · 45385

    Office

    $504.11

    Facility

    $224.23

    $22.59 lower than Madera for the office setting.

  • Rest Of Maine

    Maine · 45385

    Office

    $466.85

    Facility

    $212.42

    $59.85 lower than Madera for the office setting.

  • Southern Maine

    Maine · 45385

    Office

    $490.72

    Facility

    $216.65

    $35.98 lower than Madera for the office setting.

  • Detroit

    Michigan · 45385

    Office

    $500.01

    Facility

    $233.13

    $26.69 lower than Madera for the office setting.

  • Rest Of Michigan

    Michigan · 45385

    Office

    $473.15

    Facility

    $220.65

    $53.55 lower than Madera for the office setting.

  • Minnesota

    Minnesota · 45385

    Office

    $497.71

    Facility

    $213.13

    $28.99 lower than Madera for the office setting.

  • Metropolitan Kansas City

    Missouri · 45385

    Office

    $479.25

    Facility

    $219.56

    $47.45 lower than Madera for the office setting.

  • Metropolitan St. Louis

    Missouri · 45385

    Office

    $484.01

    Facility

    $220.73

    $42.69 lower than Madera for the office setting.

  • Rest Of Missouri

    Missouri · 45385

    Office

    $453.48

    Facility

    $215.08

    $73.22 lower than Madera for the office setting.

  • Mississippi

    Mississippi · 45385

    Office

    $449.14

    Facility

    $211.02

    $77.56 lower than Madera for the office setting.

  • Montana**

    Montana · 45385

    Office

    $499.98

    Facility

    $223.42

    $26.72 lower than Madera for the office setting.

  • North Carolina

    North Carolina · 45385

    Office

    $471.48

    Facility

    $213.45

    $55.22 lower than Madera for the office setting.

  • North Dakota**

    North Dakota · 45385

    Office

    $489.89

    Facility

    $213.33

    $36.81 lower than Madera for the office setting.

  • Nebraska

    Nebraska · 45385

    Office

    $463.70

    Facility

    $208.43

    $63.00 lower than Madera for the office setting.

  • New Hampshire

    New Hampshire · 45385

    Office

    $511.58

    Facility

    $223.68

    $15.12 lower than Madera for the office setting.

  • Northern Nj

    New Jersey · 45385

    Office

    $564.00

    Facility

    $243.19

    $37.30 higher than Madera for the office setting.

  • Rest Of New Jersey

    New Jersey · 45385

    Office

    $538.35

    Facility

    $236.35

    $11.65 higher than Madera for the office setting.

  • New Mexico

    New Mexico · 45385

    Office

    $475.71

    Facility

    $222.11

    $50.99 lower than Madera for the office setting.

  • Nevada**

    Nevada · 45385

    Office

    $497.50

    Facility

    $220.66

    $29.20 lower than Madera for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45385

    Office

    $587.27

    Facility

    $258.44

    $60.57 higher than Madera for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45385

    Office

    $542.02

    Facility

    $239.19

    $15.32 higher than Madera for the office setting.

  • Queens

    New York · 45385

    Office

    $577.86

    Facility

    $250.97

    $51.16 higher than Madera for the office setting.

  • Rest Of New York

    New York · 45385

    Office

    $478.25

    Facility

    $215.52

    $48.45 lower than Madera for the office setting.

  • Ohio

    Ohio · 45385

    Office

    $471.09

    Facility

    $218.59

    $55.61 lower than Madera for the office setting.

  • Oklahoma

    Oklahoma · 45385

    Office

    $460.47

    Facility

    $213.51

    $66.23 lower than Madera for the office setting.

  • Portland

    Oregon · 45385

    Office

    $535.11

    Facility

    $227.85

    $8.41 higher than Madera for the office setting.

  • Rest Of Oregon

    Oregon · 45385

    Office

    $493.62

    Facility

    $218.16

    $33.08 lower than Madera for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45385

    Office

    $519.67

    Facility

    $231.78

    $7.03 lower than Madera for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45385

    Office

    $471.69

    Facility

    $217.80

    $55.01 lower than Madera for the office setting.

  • Puerto Rico

    Puerto Rico · 45385

    Office

    $503.43

    Facility

    $223.83

    $23.27 lower than Madera for the office setting.

  • Rhode Island

    Rhode Island · 45385

    Office

    $512.02

    Facility

    $226.34

    $14.68 lower than Madera for the office setting.

  • South Carolina

    South Carolina · 45385

    Office

    $472.07

    Facility

    $216.53

    $54.63 lower than Madera for the office setting.

  • South Dakota**

    South Dakota · 45385

    Office

    $488.70

    Facility

    $212.14

    $38.00 lower than Madera for the office setting.

  • Tennessee

    Tennessee · 45385

    Office

    $461.73

    Facility

    $210.34

    $64.97 lower than Madera for the office setting.

  • Austin

    Texas · 45385

    Office

    $517.74

    Facility

    $225.14

    $8.96 lower than Madera for the office setting.

  • Beaumont

    Texas · 45385

    Office

    $468.74

    Facility

    $217.07

    $57.96 lower than Madera for the office setting.

  • Brazoria

    Texas · 45385

    Office

    $494.45

    Facility

    $220.38

    $32.25 lower than Madera for the office setting.

  • Dallas

    Texas · 45385

    Office

    $497.60

    Facility

    $222.14

    $29.10 lower than Madera for the office setting.

  • Fort Worth

    Texas · 45385

    Office

    $494.48

    Facility

    $221.79

    $32.22 lower than Madera for the office setting.

  • Galveston

    Texas · 45385

    Office

    $495.94

    Facility

    $221.31

    $30.76 lower than Madera for the office setting.

  • Houston

    Texas · 45385

    Office

    $505.27

    Facility

    $230.65

    $21.43 lower than Madera for the office setting.

  • Rest Of Texas

    Texas · 45385

    Office

    $481.32

    Facility

    $218.87

    $45.38 lower than Madera for the office setting.

  • Utah

    Utah · 45385

    Office

    $478.23

    Facility

    $218.27

    $48.47 lower than Madera for the office setting.

  • Virginia

    Virginia · 45385

    Office

    $489.33

    Facility

    $217.47

    $37.37 lower than Madera for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45385

    Office

    $503.43

    Facility

    $223.83

    $23.27 lower than Madera for the office setting.

  • Vermont

    Vermont · 45385

    Office

    $488.26

    Facility

    $214.46

    $38.44 lower than Madera for the office setting.

  • Rest Of Washington

    Washington · 45385

    Office

    $515.58

    Facility

    $224.36

    $11.12 lower than Madera for the office setting.

  • Seattle (King Cnty)

    Washington · 45385

    Office

    $580.16

    Facility

    $240.82

    $53.46 higher than Madera for the office setting.

  • Wisconsin

    Wisconsin · 45385

    Office

    $474.20

    Facility

    $209.25

    $52.50 lower than Madera for the office setting.

  • West Virginia

    West Virginia · 45385

    Office

    $463.60

    Facility

    $223.27

    $63.10 lower than Madera for the office setting.

  • Wyoming**

    Wyoming · 45385

    Office

    $495.58

    Facility

    $219.02

    $31.12 lower than Madera for the office setting.

See how rates vary across the country

45385 · 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.

$444.65

$591.42

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$588.561
AL$450.871
AR$444.651
AZ$487.201
CA$526.70–$656.1329
CO$519.451
CT$532.291
DC$569.431
DE$495.031
FL$493.88–$539.753
GA$467.21–$509.232
GU$538.601
HI$538.601
IA$461.351
ID$464.311
IL$480.54–$524.784
IN$466.871
KS$459.501
KY$461.491
LA$460.88–$482.622
MA$516.64–$569.042
MD$504.11–$569.433
ME$466.85–$490.722
MI$473.15–$500.012
MN$497.711
MO$453.48–$484.013
MS$449.141
MT$499.981
NC$471.481
ND$489.891
NE$463.701
NH$511.581
NJ$538.35–$564.002
NM$475.711
NV$497.501
NY$478.25–$587.275
OH$471.091
OK$460.471
OR$493.62–$535.112
PA$471.69–$519.672
PR$503.431
RI$512.021
SC$472.071
SD$488.701
TN$461.731
TX$468.74–$517.748
UT$478.231
VA$489.33–$569.432
VI$503.431
VT$488.261
WA$515.58–$580.162
WI$474.201
WV$463.601
WY$495.581

Explore 45385 on the national rate map →

Where does this rate apply?

Madera is a Medicare payment area. Our Census mapping connects it to 17 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 45385 in Madera, the physician’s office rate is $526.70 and the facility-setting rate is $223.60: a difference of $303.10.

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 45385 in Madera. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$579.37

$526.70 × 110% = $579.37

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.

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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 45385 in Madera.

PPRRVU2026_Oct_nonQPP.csv

5,520

Code
45385
Physician work
4.46
Practice expense
10.00
Malpractice
0.51

GPCI2026.csv

14

Locality
Madera
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 45385 in Madera
ComponentRVULocality factorAdjusted
Physician work4.46× 1.0174.5358
Practice expense10.00× 1.09610.9600
Malpractice0.51× 0.5360.2734
Total RVUs15.7692
Conversion factor× 33.4009

Office / nonfacility rate, Madera$526.70

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 45385 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.461.017
Practice expense101.096
Malpractice0.510.536

(4.46 × 1.017 + 10 × 1.096 + 0.51 × 0.536) × $33.4009 = $526.70

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.461.017
Practice expense1.721.096
Malpractice0.510.536

(4.46 × 1.017 + 1.72 × 1.096 + 0.51 × 0.536) × $33.4009 = $223.60

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

45385 · Office / nonfacility

$526.70

Effective 2026-10-01

The base rate is $72.16 higher than on 2025-10-01, moving from $454.54 to $526.70 (15.9%).

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

    $454.54changed to$526.70

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.57 changed to 4.46
    • Practice expense RVU 8.33 changed to 10.00
    • Malpractice RVU 0.56 changed to 0.51
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $454.54

    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$526.70$223.60RVU26D
2026-07-01$526.70$223.60RVU26C
2026-04-01$526.70$223.60RVU26B
2026-01-01$526.70$223.60RVU26A
2025-10-01$454.54$244.18RVU25D
2025-07-01$454.54$244.18RVU25C
2025-04-01$454.54$244.18RVU25B
2025-01-01$454.54$244.18RVU25A

45385 billing questions

How many units are reported when several polyps are removed by snare?

One unit. The code covers all lesions removed by snare during the session, regardless of their number or location.

Can 45380 be reported with 45385 in the same session?

Yes, when a separate lesion is biopsied. Use modifier 59 on 45380 when needed to identify the distinct lesion; a biopsy of the lesion subsequently removed by snare is included in 45385.

What happens when a Medicare screening colonoscopy turns into a polypectomy?

Report 45385 instead of the screening G code and append modifier PT to identify the procedure as a screening that became therapeutic. The Medicare screening-related deductible waiver then applies.

Should 45385 or 45390 be reported when a polyp is lifted with an injection before snaring?

An injection lift alone does not establish endoscopic mucosal resection. Report 45390 when the procedure report supports that resection technique; do not add 45385 or 45381 for the same lesion's resection and lift.

Can a tattoo injection be added to 45385?

A documented submucosal ink injection to mark the polypectomy site may be reported with 45381. When both services are payable, endoscopy family pricing applies.

How do snare and hot biopsy forceps removal differ for coding?

Snare removal, hot or cold, is reported with 45385. Removal with hot biopsy forceps or bipolar cautery is reported with 45384; when different lesions are treated by both methods, a distinct-procedure modifier may be needed.

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 45385PPRRVU2026_Oct_nonQPP.csv, line 5,520 (RVU26D)
Geographic factors for MaderaGPCI2026.csv, line 14 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet