No office rate
Both involve endoscopic stent placement, but 45347 is for flexible sigmoidoscopy; 45389 is for colonoscopy.
On this page
CMS RVU26D · Effective 2026-10-01
45389 Colonoscopy Medicare reimbursement rates in Colorado
Reports colonoscopic deployment of a stent across a colonic narrowing, commonly to relieve obstruction or maintain luminal patency. Compare 45389 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 45389 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
No supported rate
Facility setting
$255.02
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 45389: Colonoscopy with colonic stent placement
Reports colonoscopic deployment of a stent across a colonic narrowing, commonly to relieve obstruction or maintain luminal patency.
A therapeutic endoscopist advances a colonoscope to a narrowed segment and deploys a stent through the instrument to maintain or restore passage through the colon. A common setting is an obstructing colorectal tumor, where stenting may relieve symptoms or serve as a bridge to planned surgery. Gastroenterologists and colorectal surgeons typically perform the service in a hospital or ambulatory surgery center, with imaging support when needed to guide placement.
Select this service when the colonoscopic procedure includes stent deployment, not for diagnostic inspection alone or balloon dilation without a stent. The report should identify the site and cause of the narrowing, the stent placed, and how deployment was completed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 45389
- 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 RVU5.11 · 67%
- Practice expense (office) RVU1.89 · 25%
- Malpractice RVU0.58 · 8%
393
Medicare services in 2024 · #3753 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.
45389 compared with similar codes
Office rates for Colorado, from the same CMS release.
$702.71
45386 treats a colonic narrowing with balloon dilation. Choose 45389 when a stent is deployed through the colonoscope.
$392.90
45378 is diagnostic colonoscopy without the therapeutic stent placement reported by 45389.
No office rate
45393 reports colonoscopic decompression; 45389 reports placement of a stent across a narrowed colonic segment.
Compare 45389 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
Unavailable
Facility
$255.02
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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 45389 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
5,523
- Code
- 45389
- Physician work
- 5.11
- Practice expense
- 1.89
- Malpractice
- 0.58
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.11 | × 1.012 | 5.1713 |
| Practice expense | 1.89 | × 1.064 | 2.0110 |
| Malpractice | 0.58 | × 0.781 | 0.4530 |
| Total RVUs | 7.6353 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$255.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.11 | 1.012 |
| Practice expense | 1.89 | 1.064 |
| Malpractice | 0.58 | 0.781 |
(5.11 × 1.012 + 1.89 × 1.064 + 0.58 × 0.781) × $33.4009 = $255.02
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.
45389 billing questions
When should 45389 be selected instead of 45347?
Use 45389 for stent placement performed through a colonoscopy. Code 45347 describes stent placement using flexible sigmoidoscopy, when the service is limited to that examination.
Is balloon dilation reported separately when a stent is placed?
45389 represents colonoscopic stent placement. Review the operative details and applicable coding edits before separately reporting another therapeutic endoscopy performed during the same session.
Can diagnostic colonoscopy be separately reported with 45389?
The inspection needed to reach and treat the narrowing is part of the therapeutic colonoscopy. When related endoscopies are performed together, CMS endoscopy family pricing applies.
What documentation supports 45389?
Document the location and cause of the narrowing, the reason for stenting, and the stent deployment details, including the device and final position.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can an assistant or co-surgeon be reported?
CMS 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.
5,52045385,,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
5,52645392,,Colonoscopy w/endoscopic fnb,A,,5.36,1.99,NA,1.99,,0.61,7.96,7.96,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
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