$398.34–$497.55
45378 represents diagnostic colonoscopy without therapeutic bleeding control. Use 45382 when the endoscopist treats an identified bleeding source.
On this page
CMS RVU26D · Effective 2026-10-01
45382 Colonoscopy Medicare reimbursement rates in California
Reports colonoscopy with endoscopic treatment of active colonic bleeding, such as bleeding from angiodysplasia, a diverticulum, or a prior procedure site. Compare 45382 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 45382 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$778.91–$987.39
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $208.48 per service.
Facility setting
$227.23–$261.56
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $34.33 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 45382 pays more and less in California
29 payment localities
$778.91 to $987.39
Gastroenterology
About 45382: Colonoscopy with bleeding control
Reports colonoscopy with endoscopic treatment of active colonic bleeding, such as bleeding from angiodysplasia, a diverticulum, or a prior procedure site.
A gastroenterologist or other qualified endoscopist uses a colonoscope to locate and treat a bleeding source in the colon. Hemostasis may involve a clip, thermal treatment, or injection, depending on the source and clinical circumstances. Examples include active bleeding from angiodysplasia or a diverticulum, and bleeding at a prior polypectomy site. The service is commonly performed in a hospital outpatient department or ambulatory surgery center.
Select this code when the colonoscopy includes treatment to control bleeding, not merely inspection or routine hemostasis integral to another intervention. The procedure report should identify the bleeding site, findings, treatment method, and response. The code 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; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 45382
- 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 RVU4.54 · 21%
- Practice expense (office) RVU16.82 · 77%
- Malpractice RVU0.50 · 2%
22.4K
Medicare services in 2024 · #1097 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.
45382 compared with similar codes
Office rates for California, from the same CMS release.
$520.38–$655.86
45381 represents submucosal injection, such as for marking or lifting a lesion. Use 45382 when injection is performed to control bleeding.
$526.70–$656.13
45385 is for snare removal of a lesion. 45382 is for endoscopic treatment of bleeding, not removal of the bleeding lesion.
$967.09–$1,237.77
45398 identifies colonoscopy with band ligation. Use it when band ligation is the documented intervention rather than reporting bleeding control generically.
Compare 45382 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $780.43 | Facility $228.75 |
| Chico | Office $778.91 | Facility $227.23 |
| El Centro | Office $778.99 | Facility $227.32 |
| Fresno | Office $778.91 | Facility $227.23 |
| Hanford-Corcoran | Office $778.91 | Facility $227.23 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $833.56 | Facility $238.09 |
| Madera | Office $778.91 | Facility $227.23 |
| Merced | Office $778.91 | Facility $227.23 |
| Modesto | Office $778.91 | Facility $227.23 |
| Napa | Office $910.13 | Facility $246.72 |
| Oxnard-Thousand Oaks-Ventura | Office $830.34 | Facility $235.38 |
| Redding | Office $778.91 | Facility $227.23 |
| Rest Of California | Office $778.91 | Facility $227.23 |
| Riverside-San Bernardino-Ontario | Office $784.35 | Facility $232.68 |
| Sacramento-Roseville-Folsom | Office $819.43 | Facility $234.03 |
| Salinas | Office $816.42 | Facility $233.04 |
| San Diego-Chula Vista-Carlsbad | Office $837.16 | Facility $235.15 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $965.85 | Facility $256.13 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $965.29 | Facility $255.56 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $987.39 | Facility $261.56 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $985.07 | Facility $259.24 |
| San Luis Obispo-Paso Robles | Office $803.06 | Facility $229.75 |
| Santa Cruz-Watsonville | Office $846.37 | Facility $234.79 |
| Santa Maria-Santa Barbara | Office $819.90 | Facility $232.99 |
| Santa Rosa-Petaluma | Office $855.03 | Facility $236.92 |
| Stockton | Office $778.91 | Facility $227.23 |
| Vallejo | Office $909.32 | Facility $245.90 |
| Visalia | Office $778.91 | Facility $227.23 |
| Yuba City | Office $778.91 | Facility $227.23 |
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45382 billing questions
When should this code be selected instead of diagnostic colonoscopy?
Use it when the endoscopist performs treatment to control bleeding during the colonoscopy. A diagnostic examination without endoscopic bleeding treatment is reported with 45378.
Can diagnostic colonoscopy be reported separately on the same claim?
The examination is part of the therapeutic colonoscopy, so do not separately report 45378 for the same procedure.
Is this code appropriate for routine hemostasis during polyp removal?
Do not use it for hemostasis that is integral to another intervention, such as routine control of bleeding during lesion removal. Document a separately performed service to control a bleeding source.
How does CMS price this with another endoscopy performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. The claim should identify the procedures actually performed; CMS applies the family pricing methodology.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. CMS statutorily restricts assistant-at-surgery payment, and co-surgeons and team surgery are not permitted.
What documentation supports reporting bleeding control?
Document the bleeding source or site, the endoscopic treatment used, and the result. Findings alone, without treatment to control bleeding, do not support this therapeutic service.
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.
5,51545379,,Colonoscopy w/fb removal,A,,4.17,9.69,,1.63,,0.49,14.35,6.29,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,51645380,,Colonoscopy and biopsy,A,,3.47,10.48,,1.43,,0.42,14.37,5.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,51745381,,Colonoscopy submucous njx,A,,3.47,10.79,,1.43,,0.42,14.68,5.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,51845382,,Colonoscopy w/control bleed,A,,4.54,16.82,,1.75,,0.50,21.86,6.79,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,51945384,,Colonoscopy w/lesion removal,A,,3.97,11.57,,1.51,,0.61,16.15,6.09,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52045385,,Colonoscopy w/lesion removal,A,,4.46,10.00,,1.72,,0.51,14.97,6.69,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52145386,,Colonoscopy w/balloon dilat,A,,3.68,15.95,,1.49,,0.44,20.07,5.61,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00