No office rate
Choose 45391 for colonoscopy with EUS examination alone. Choose 45392 when EUS guides fine-needle aspiration or biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
45391 Colonoscopy EUS Medicare reimbursement rates in Connecticut
Reports a full colonoscopy with endoscopic ultrasound to assess bowel-wall lesions, rectal abnormalities, or nearby structures without EUS-guided tissue sampling. Compare 45391 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 45391 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
No supported rate
Facility setting
$237.11
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 45391: Colonoscopy with endoscopic ultrasound
Reports a full colonoscopy with endoscopic ultrasound to assess bowel-wall lesions, rectal abnormalities, or nearby structures without EUS-guided tissue sampling.
A gastroenterologist or other qualified endoscopist advances a colonoscope to examine the colon and uses an ultrasound transducer during the procedure to assess bowel-wall layers and adjacent anatomy. Common reasons include evaluating a subepithelial lesion, characterizing a rectal mass, or assessing local rectal cancer extent. The procedure is typically performed in a hospital endoscopy unit or ambulatory endoscopy center.
Select this code when the colonoscopy includes endoscopic ultrasound examination without ultrasound-guided needle sampling; when EUS guides fine-needle aspiration or biopsy, compare 45392. The report should identify the findings and document the ultrasound examination. 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 45391
- 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 RVU4.52 · 67%
- Practice expense (office) RVU1.76 · 26%
- Malpractice RVU0.49 · 7%
713
Medicare services in 2024 · #3244 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.
45391 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
45341 is sigmoidoscopy with ultrasound, while 45391 describes colonoscopy with ultrasound. Select based on the scope examination performed.
No office rate
45342 combines sigmoidoscopy, ultrasound, and ultrasound-guided biopsy; 45391 is the colonoscopy EUS examination without that guided sampling.
$402.98
45378 is diagnostic colonoscopy without EUS. Use 45391 when endoscopic ultrasound is also performed during the colonoscopy.
Compare 45391 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
Unavailable
Facility
$237.11
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 45391 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
5,525
- Code
- 45391
- Physician work
- 4.52
- Practice expense
- 1.76
- Malpractice
- 0.49
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.52 | × 1.020 | 4.6104 |
| Practice expense | 1.76 | × 1.077 | 1.8955 |
| Malpractice | 0.49 | × 1.210 | 0.5929 |
| Total RVUs | 7.0988 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$237.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.52 | 1.02 |
| Practice expense | 1.76 | 1.077 |
| Malpractice | 0.49 | 1.21 |
(4.52 × 1.02 + 1.76 × 1.077 + 0.49 × 1.21) × $33.4009 = $237.11
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.
45391 billing questions
When should 45392 be used instead?
Use 45392 when endoscopic ultrasound guides fine-needle aspiration or biopsy. Code 45391 describes the ultrasound examination without that guided tissue-sampling service.
Can diagnostic colonoscopy 45378 also be reported for the same session?
The diagnostic inspection that is part of the same colonoscopy is included; do not separately report 45378 for that same examination.
How does 45391 differ from sigmoidoscopy with ultrasound?
45391 describes colonoscopy with EUS. For an examination limited to the sigmoid colon or rectum, compare the sigmoidoscopy ultrasound code 45341.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code because the descriptor or anatomy does not support bilateral reporting.
What happens when related endoscopies are performed in the same session?
CMS applies endoscopy family pricing to related endoscopies performed together. The claim should reflect the procedures actually performed, with payment determined under that family rule.
What documentation supports reporting 45391?
Document the colonoscopy, the endoscopic ultrasound examination, the anatomy assessed, and the findings. If EUS-guided needle sampling was performed, evaluate 45392 instead.
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.
5,52245388,,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
5,52745393,,Colonoscopy w/decompression,A,,4.56,1.42,NA,1.42,,0.56,6.54,6.54,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52845395,,Lap removal of rectum,A,,32.18,15.69,NA,15.69,,6.00,53.87,53.87,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,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