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CMS RVU26D · Effective 2026-10-01

45398 in Merced

Office / nonfacility

$967.09

Base rate per service

Facility setting

$207.49

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.

Gastroenterology

About 45398: Colonoscopy with hemorrhoid band ligation

Reports colonoscopy with endoscopic band ligation of hemorrhoids when the intervention is performed during examination of the colon.

A gastroenterologist, colorectal surgeon, or other qualified endoscopist performs a colonoscopy and places bands endoscopically to treat hemorrhoidal tissue, commonly internal hemorrhoids. The colonoscope is used to reach and treat the target during the same procedure; this is distinct from band ligation performed through a sigmoidoscope, which examines a shorter portion of the bowel.

Report this code when the colonoscopy includes hemorrhoid band ligation, and document the examination, hemorrhoid treatment, and procedure performed. A diagnostic inspection during the same session is part of the therapeutic colonoscopy rather than a separate diagnostic colonoscopy claim. The service 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. CMS does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 45398

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 RVU4.10 · 15%
  • Practice expense (office) RVU22.32 · 83%
  • Malpractice RVU0.60 · 2%

4.6K

Medicare services in 2024 · #1935 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.

45398 compared with similar codes

Office rates for Merced, from the same CMS release.

45350

Sigmoidoscopy

Endoscopic band ligation

$806.63

Both involve endoscopic band ligation, but 45398 is performed during colonoscopy; 45350 is performed during sigmoidoscopy.

45378

Colonoscopy

Diagnostic, no tissue removal

$398.34

45378 describes diagnostic colonoscopy without the band-ligation intervention. Use 45398 when hemorrhoid band ligation is performed during the colonoscopy.

45382

Colonoscopy

Control of bleeding

$778.91

45382 is for endoscopic control of bleeding. 45398 is specific to colonoscopy with hemorrhoid band ligation.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 45398 is $968.83—$1.74 higher than the $967.09 rate in Merced. Both use the same code, release and participation basis.

45398 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $967.09

  2. Bakersfield

    $968.83

    $1.74 higher than Merced

  3. Chico

    $967.09

    The same base rate than Merced

  4. El Centro

    $967.19

    $0.10 higher than Merced

  5. Fresno

    $967.09

    The same base rate than Merced

  6. Hanford-Corcoran

    $967.09

    The same base rate than Merced

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

    $1037.80

    $70.71 higher than Merced

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, 45398 ranges from $787.66 in Arkansas to $1237.77 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

  • Madera

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Modesto

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Napa

    California · 45398

    Office

    $1138.33

    Facility

    $224.87

    $171.24 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45398

    Office

    $1034.45

    Facility

    $215.25

    $67.36 higher than Merced for the office setting.

  • Redding

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45398

    Office

    $973.58

    Facility

    $213.98

    $6.49 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45398

    Office

    $1019.64

    Facility

    $213.60

    $52.55 higher than Merced for the office setting.

  • Salinas

    California · 45398

    Office

    $1015.97

    Facility

    $212.71

    $48.88 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45398

    Office

    $1043.54

    Facility

    $214.63

    $76.45 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45398

    Office

    $1210.32

    Facility

    $233.09

    $243.23 higher than Merced for the office setting.

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

    California · 45398

    Office

    $1209.64

    Facility

    $232.41

    $242.55 higher than Merced for the office setting.

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

    California · 45398

    Office

    $1237.77

    Facility

    $238.37

    $270.68 higher than Merced for the office setting.

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

    California · 45398

    Office

    $1234.99

    Facility

    $235.58

    $267.90 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45398

    Office

    $999.15

    Facility

    $209.74

    $32.06 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 45398

    Office

    $1056.35

    Facility

    $214.28

    $89.26 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 45398

    Office

    $1020.78

    Facility

    $212.66

    $53.69 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 45398

    Office

    $1067.28

    Facility

    $216.19

    $100.19 higher than Merced for the office setting.

  • Stockton

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 45398

    Office

    $1137.35

    Facility

    $223.88

    $170.26 higher than Merced for the office setting.

  • Visalia

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 45398

    Office

    $967.09

    Facility

    $207.49

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45398

    Office

    $1044.85

    Facility

    $228.42

    $77.76 higher than Merced for the office setting.

  • Miami

    Florida · 45398

    Office

    $963.70

    Facility

    $242.22

    $3.39 lower than Merced for the office setting.

  • Chicago

    Illinois · 45398

    Office

    $933.13

    Facility

    $236.60

    $33.96 lower than Merced for the office setting.

  • Manhattan

    New York · 45398

    Office

    $1043.77

    Facility

    $238.43

    $76.68 higher than Merced for the office setting.

  • Alaska*

    Alaska · 45398

    Office

    $1010.42

    Facility

    $272.31

    $43.33 higher than Merced for the office setting.

  • Alabama

    Alabama · 45398

    Office

    $800.61

    Facility

    $194.17

    $166.48 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 45398

    Office

    $787.66

    Facility

    $192.31

    $179.43 lower than Merced for the office setting.

  • Arizona

    Arizona · 45398

    Office

    $876.50

    Facility

    $204.91

    $90.59 lower than Merced for the office setting.

  • Colorado

    Colorado · 45398

    Office

    $947.46

    Facility

    $210.03

    $19.63 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 45398

    Office

    $966.84

    Facility

    $220.41

    $0.25 lower than Merced for the office setting.

  • Delaware

    Delaware · 45398

    Office

    $892.21

    Facility

    $207.45

    $74.88 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 45398

    Office

    $928.38

    Facility

    $226.30

    $38.71 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 45398

    Office

    $879.77

    Facility

    $217.20

    $87.32 lower than Merced for the office setting.

  • Atlanta

    Georgia · 45398

    Office

    $918.86

    Facility

    $214.70

    $48.23 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 45398

    Office

    $825.83

    Facility

    $207.61

    $141.26 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 45398

    Office

    $996.19

    Facility

    $208.17

    $29.10 higher than Merced for the office setting.

  • Iowa

    Iowa · 45398

    Office

    $827.04

    Facility

    $192.88

    $140.05 lower than Merced for the office setting.

  • Idaho

    Idaho · 45398

    Office

    $832.29

    Facility

    $194.67

    $134.80 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 45398

    Office

    $863.17

    Facility

    $225.55

    $103.92 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 45398

    Office

    $848.92

    Facility

    $216.14

    $118.17 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 45398

    Office

    $939.05

    Facility

    $227.27

    $28.04 lower than Merced for the office setting.

  • Indiana

    Indiana · 45398

    Office

    $837.77

    Facility

    $195.29

    $129.32 lower than Merced for the office setting.

  • Kansas

    Kansas · 45398

    Office

    $820.98

    Facility

    $194.45

    $146.11 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 45398

    Office

    $818.04

    Facility

    $201.90

    $149.05 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 45398

    Office

    $861.23

    Facility

    $209.06

    $105.86 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 45398

    Office

    $815.92

    Facility

    $202.55

    $151.17 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 45398

    Office

    $1050.53

    Facility

    $223.01

    $83.44 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45398

    Office

    $940.13

    Facility

    $210.33

    $26.96 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45398

    Office

    $963.86

    Facility

    $220.19

    $3.23 lower than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 45398

    Office

    $911.16

    Facility

    $209.78

    $55.93 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 45398

    Office

    $835.28

    Facility

    $197.65

    $131.81 lower than Merced for the office setting.

  • Southern Maine

    Maine · 45398

    Office

    $888.39

    Facility

    $201.56

    $78.70 lower than Merced for the office setting.

  • Detroit

    Michigan · 45398

    Office

    $890.15

    Facility

    $221.34

    $76.94 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 45398

    Office

    $840.22

    Facility

    $207.45

    $126.87 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 45398

    Office

    $910.00

    Facility

    $196.84

    $57.09 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 45398

    Office

    $856.56

    Facility

    $205.76

    $110.53 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 45398

    Office

    $866.75

    Facility

    $206.95

    $100.34 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 45398

    Office

    $799.09

    Facility

    $201.67

    $168.00 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 45398

    Office

    $793.64

    Facility

    $196.90

    $173.45 lower than Merced for the office setting.

  • Montana**

    Montana · 45398

    Office

    $902.45

    Facility

    $209.38

    $64.64 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 45398

    Office

    $845.31

    Facility

    $198.68

    $121.78 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 45398

    Office

    $890.59

    Facility

    $197.52

    $76.50 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 45398

    Office

    $832.62

    Facility

    $192.92

    $134.47 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 45398

    Office

    $930.55

    Facility

    $209.07

    $36.54 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 45398

    Office

    $1031.76

    Facility

    $227.80

    $64.67 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 45398

    Office

    $978.50

    Facility

    $221.67

    $11.41 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 45398

    Office

    $844.64

    Facility

    $209.10

    $122.45 lower than Merced for the office setting.

  • Nevada**

    Nevada · 45398

    Office

    $899.89

    Facility

    $206.13

    $67.20 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45398

    Office

    $1069.33

    Facility

    $245.27

    $102.24 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45398

    Office

    $983.69

    Facility

    $224.78

    $16.60 higher than Merced for the office setting.

  • Queens

    New York · 45398

    Office

    $1055.80

    Facility

    $236.59

    $88.71 higher than Merced for the office setting.

  • Rest Of New York

    New York · 45398

    Office

    $859.26

    Facility

    $200.85

    $107.83 lower than Merced for the office setting.

  • Ohio

    Ohio · 45398

    Office

    $837.79

    Facility

    $205.02

    $129.30 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 45398

    Office

    $818.25

    Facility

    $199.34

    $148.84 lower than Merced for the office setting.

  • Portland

    Oregon · 45398

    Office

    $982.30

    Facility

    $212.31

    $15.21 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 45398

    Office

    $893.56

    Facility

    $203.26

    $73.53 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45398

    Office

    $939.39

    Facility

    $217.91

    $27.70 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45398

    Office

    $840.26

    Facility

    $204.02

    $126.83 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 45398

    Office

    $910.39

    Facility

    $209.70

    $56.70 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 45398

    Office

    $927.53

    Facility

    $211.59

    $39.56 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 45398

    Office

    $842.83

    Facility

    $202.43

    $124.26 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 45398

    Office

    $889.19

    Facility

    $196.12

    $77.90 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 45398

    Office

    $825.37

    Facility

    $195.37

    $141.72 lower than Merced for the office setting.

  • Austin

    Texas · 45398

    Office

    $943.72

    Facility

    $210.45

    $23.37 lower than Merced for the office setting.

  • Beaumont

    Texas · 45398

    Office

    $833.97

    Facility

    $203.28

    $133.12 lower than Merced for the office setting.

  • Brazoria

    Texas · 45398

    Office

    $892.47

    Facility

    $205.64

    $74.62 lower than Merced for the office setting.

  • Dallas

    Texas · 45398

    Office

    $897.90

    Facility

    $207.60

    $69.19 lower than Merced for the office setting.

  • Fort Worth

    Texas · 45398

    Office

    $890.70

    Facility

    $207.34

    $76.39 lower than Merced for the office setting.

  • Galveston

    Texas · 45398

    Office

    $894.92

    Facility

    $206.71

    $72.17 lower than Merced for the office setting.

  • Houston

    Texas · 45398

    Office

    $905.90

    Facility

    $217.69

    $61.19 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 45398

    Office

    $862.53

    Facility

    $204.81

    $104.56 lower than Merced for the office setting.

  • Utah

    Utah · 45398

    Office

    $855.72

    Facility

    $204.23

    $111.37 lower than Merced for the office setting.

  • Virginia

    Virginia · 45398

    Office

    $883.93

    Facility

    $202.64

    $83.16 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45398

    Office

    $910.39

    Facility

    $209.70

    $56.70 lower than Merced for the office setting.

  • Vermont

    Vermont · 45398

    Office

    $885.14

    Facility

    $199.00

    $81.95 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 45398

    Office

    $938.99

    Facility

    $209.19

    $28.10 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 45398

    Office

    $1074.90

    Facility

    $224.51

    $107.81 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 45398

    Office

    $857.31

    Facility

    $193.35

    $109.78 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 45398

    Office

    $813.47

    Facility

    $211.19

    $153.62 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 45398

    Office

    $897.28

    Facility

    $204.21

    $69.81 lower than Merced for the office setting.

See how rates vary across the country

45398 · 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.

$787.66

$1,102.43

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$1,010.421
AL$800.611
AR$787.661
AZ$876.501
CA$967.09–$1,237.7729
CO$947.461
CT$966.841
DC$1,044.851
DE$892.211
FL$879.77–$963.703
GA$825.83–$918.862
GU$996.191
HI$996.191
IA$827.041
ID$832.291
IL$848.92–$939.054
IN$837.771
KS$820.981
KY$818.041
LA$815.92–$861.232
MA$940.13–$1,050.532
MD$911.16–$1,044.853
ME$835.28–$888.392
MI$840.22–$890.152
MN$910.001
MO$799.09–$866.753
MS$793.641
MT$902.451
NC$845.311
ND$890.591
NE$832.621
NH$930.551
NJ$978.50–$1,031.762
NM$844.641
NV$899.891
NY$859.26–$1,069.335
OH$837.791
OK$818.251
OR$893.56–$982.302
PA$840.26–$939.392
PR$910.391
RI$927.531
SC$842.831
SD$889.191
TN$825.371
TX$833.97–$943.728
UT$855.721
VA$883.93–$1,044.852
VI$910.391
VT$885.141
WA$938.99–$1,074.902
WI$857.311
WV$813.471
WY$897.281

Explore 45398 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 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 45398 in Merced, the physician’s office rate is $967.09 and the facility-setting rate is $207.49: a difference of $759.60.

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 45398 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$1063.80

$967.09 × 110% = $1063.80

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 45398 in Merced.

PPRRVU2026_Oct_nonQPP.csv

5,530

Code
45398
Physician work
4.10
Practice expense
22.32
Malpractice
0.60

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 45398 in Merced
ComponentRVULocality factorAdjusted
Physician work4.10× 1.0174.1697
Practice expense22.32× 1.09624.4627
Malpractice0.60× 0.5360.3216
Total RVUs28.9540
Conversion factor× 33.4009

Office / nonfacility rate, Merced$967.09

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

Open 45398 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.11.017
Practice expense22.321.096
Malpractice0.60.536

(4.1 × 1.017 + 22.32 × 1.096 + 0.6 × 0.536) × $33.4009 = $967.09

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.11.017
Practice expense1.571.096
Malpractice0.60.536

(4.1 × 1.017 + 1.57 × 1.096 + 0.6 × 0.536) × $33.4009 = $207.49

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

45398 · Office / nonfacility

$967.09

Effective 2026-10-01

The base rate is $149.36 higher than on 2025-10-01, moving from $817.73 to $967.09 (18.3%).

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

    $817.73changed to$967.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.20 changed to 4.10
    • Practice expense RVU 18.91 changed to 22.32
    • Malpractice RVU 0.63 changed to 0.60
    • 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: $817.73

    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$967.09$207.49RVU26D
2026-07-01$967.09$207.49RVU26C
2026-04-01$967.09$207.49RVU26B
2026-01-01$967.09$207.49RVU26A
2025-10-01$817.73$224.83RVU25D
2025-07-01$817.73$224.83RVU25C
2025-04-01$817.73$224.83RVU25B
2025-01-01$817.73$224.83RVU25A

45398 billing questions

When should 45398 be selected instead of 45350?

Use 45398 when the band ligation is performed during colonoscopy. Use 45350 when the procedure is performed with a sigmoidoscope rather than a colonoscope.

Can the diagnostic colonoscopy be reported separately?

Do not separately report a diagnostic colonoscopy for the inspection that is part of the same therapeutic colonoscopy with band ligation.

How are related endoscopies handled in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together. Document the procedures performed during the session.

Should modifier 50 be appended for multiple hemorrhoids?

No. CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Can an assistant, co-surgeon, or surgical team be billed?

CMS does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What does the 0-day global period include?

Same-day preoperative and postoperative care is included in the procedure.

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 45398PPRRVU2026_Oct_nonQPP.csv, line 5,530 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet