$561.29
Use 45384 when hot biopsy forceps or bipolar cautery removes lesion tissue. Use 45388 when the treatment destroys the lesion rather than removing it.
On this page
CMS RVU26D · Effective 2026-10-01
45388 Colonoscopy ablation Medicare reimbursement rates in Colorado
Reports colonoscopic destruction of a tumor, polyp, or other lesion, such as residual adenomatous tissue treated with endoscopic energy. Compare 45388 office and facility rates across CMS payment localities in Colorado.
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 45388 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$2815.64
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$239.81
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Gastrointestinal endoscopy
About 45388: Colonoscopy with lesion ablation
Reports colonoscopic destruction of a tumor, polyp, or other lesion, such as residual adenomatous tissue treated with endoscopic energy.
A gastroenterologist or colorectal surgeon uses a flexible colonoscope to destroy lesion tissue rather than remove it as a specimen. Ablation may use methods such as argon plasma coagulation or electrocautery. A typical situation is treating residual adenomatous tissue at a prior polypectomy site; the code also covers ablation of other appropriate colonic lesions. The service is performed in settings where colonoscopy is provided, including hospital outpatient departments and ambulatory surgery centers.
Report the code when lesion destruction is performed, and document the lesion treated and the ablation method. When related endoscopies are performed together, CMS applies endoscopy-family pricing. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 45388
- 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 RVU4.76 · 6%
- Practice expense (office) RVU74.26 · 93%
- Malpractice RVU0.60 · 1%
20.7K
Medicare services in 2024 · #1134 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.
45388 compared with similar codes
Office rates for Colorado, from the same CMS release.
$519.45
Use 45385 for snare removal of a lesion. Ablation without snare excision is reported with 45388.
$764.26
Use 45382 when the service is directed at controlling bleeding. Use 45388 when the intent is to ablate a tumor, polyp, or other lesion.
$2,643.91
Both codes describe endoscopic lesion ablation; 45346 is for flexible sigmoidoscopy, while 45388 is for colonoscopy.
Compare 45388 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
$2815.64
Facility
$239.81
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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 45388 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
5,522
- Code
- 45388
- Physician work
- 4.76
- Practice expense
- 74.26
- Malpractice
- 0.60
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.76 | × 1.012 | 4.8171 |
| Practice expense | 74.26 | × 1.064 | 79.0126 |
| Malpractice | 0.60 | × 0.781 | 0.4686 |
| Total RVUs | 84.2984 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$2815.64
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.76 | 1.012 |
| Practice expense | 74.26 | 1.064 |
| Malpractice | 0.6 | 0.781 |
(4.76 × 1.012 + 74.26 × 1.064 + 0.6 × 0.781) × $33.4009 = $2815.64
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.76 | 1.012 |
| Practice expense | 1.78 | 1.064 |
| Malpractice | 0.6 | 0.781 |
(4.76 × 1.012 + 1.78 × 1.064 + 0.6 × 0.781) × $33.4009 = $239.81
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.
45388 billing questions
How is ablation different from lesion removal?
Ablation destroys lesion tissue; removal techniques such as forceps or snare excision take tissue out. Choose the code that matches the technique documented.
Can diagnostic colonoscopy be reported separately?
Do not separately report a diagnostic colonoscopy for the same examination when lesion ablation is performed. The diagnostic inspection is part of the therapeutic colonoscopy.
Should modifier 50 be appended for treatment on both sides of the colon?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included. Care on a later date is outside this 0-day global period.
How are related endoscopies priced when performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed in the same session.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
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.
5,51945384,,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
5,52245388,,Colonoscopy w/ablation,A,,4.76,74.26,,1.78,,0.60,79.62,7.14,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52345389,,Colonoscopy w/stent plcmt,A,,5.11,1.89,NA,1.89,,0.58,7.58,7.58,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52445390,,Colonoscopy w/resection,A,,5.89,2.15,NA,2.15,,0.65,8.69,8.69,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52545391,,Colonoscopy w/endoscope us,A,,4.52,1.76,NA,1.76,,0.49,6.77,6.77,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899