$512.19
This code describes injection beneath the lining; 45380 describes taking tissue for examination. Choose based on the intervention documented.
On this page
CMS RVU26D · Effective 2026-10-01
45381 Colonoscopy injection Medicare reimbursement rates in Connecticut
Colonoscopy with directed submucosal injection is reported when an endoscopist injects beneath a colonic lesion to lift it or mark its location. Compare 45381 office and facility rates across CMS payment localities in Connecticut.
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 45381 in Connecticut?
Connecticut 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
$523.34
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$186.63
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 45381: Colonoscopy with submucosal injection
Colonoscopy with directed submucosal injection is reported when an endoscopist injects beneath a colonic lesion to lift it or mark its location.
During colonoscopy, the endoscopist directs material into the tissue layer beneath the colonic lining. Common reasons include raising a flat lesion to facilitate endoscopic treatment or tattooing a lesion site for later localization. Gastroenterologists and colorectal surgeons typically perform the service in an endoscopy unit, ambulatory surgery center, hospital, or appropriately equipped office.
Report the service when the procedure record identifies the injection site, purpose, and substance or marking method. Injections during an endoscopic mucosal resection are included in the resection service; do not separately report this code for that same injection. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies occur together, endoscopy-family pricing applies. Modifier 50 is inappropriate for this colon procedure. Medicare does not pay an assistant-at-surgery service for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 45381
- 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 RVU3.47 · 24%
- Practice expense (office) RVU10.79 · 74%
- Malpractice RVU0.42 · 3%
81.9K
Medicare services in 2024 · #621 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.
45381 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$779.94
Use 45382 when the endoscopist treats bleeding. Injection to lift or mark a lesion is the service described here.
No office rate
When injection is part of endoscopic mucosal resection, 45390 includes it. Do not separately report this code for that same injection.
Compare 45381 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
Connecticut →
Office / nonfacility
$523.34
Facility
$186.63
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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 45381 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
5,517
- Code
- 45381
- Physician work
- 3.47
- Practice expense
- 10.79
- Malpractice
- 0.42
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.47 | × 1.020 | 3.5394 |
| Practice expense | 10.79 | × 1.077 | 11.6208 |
| Malpractice | 0.42 | × 1.210 | 0.5082 |
| Total RVUs | 15.6684 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$523.34
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.47 | 1.02 |
| Practice expense | 10.79 | 1.077 |
| Malpractice | 0.42 | 1.21 |
(3.47 × 1.02 + 10.79 × 1.077 + 0.42 × 1.21) × $33.4009 = $523.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.47 | 1.02 |
| Practice expense | 1.43 | 1.077 |
| Malpractice | 0.42 | 1.21 |
(3.47 × 1.02 + 1.43 × 1.077 + 0.42 × 1.21) × $33.4009 = $186.63
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.
45381 billing questions
When should this code be chosen instead of a biopsy code?
Use it for directed injection beneath the colonic lining, such as lifting or marking a lesion. Use the biopsy code when tissue sampling is the intervention.
Can it be reported with endoscopic mucosal resection?
The mucosal resection code includes submucosal injection when performed as part of that resection. Do not separately report this code for the same injection.
How many units should be reported for several injections?
Multiple directed injections during one colonoscopy do not create separate units; the code covers injection or injections.
What documentation supports reporting it?
Record the colonic site, why material was injected, and the substance or marking method used. Document whether the injection lifted a lesion or marked its location.
Which modifiers or surgical-assistance services are appropriate?
Modifier 50 is inappropriate for this colon procedure. Medicare does not pay an assistant-at-surgery service for this code, and co-surgeon and team-surgery reporting 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.
5,51445378,53,Diagnostic colonoscopy,A,,1.59,3.87,,0.67,,0.21,5.67,2.47,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808