Billing code 45382: ColonoscopyMedicare rate & RVUs in Florida
Reports colonoscopy with endoscopic treatment of active colonic bleeding, such as bleeding from angiodysplasia, a diverticulum, or a prior procedure site.
Medicare pays $713.82–$778.71 for 45382 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 45382 covers
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.
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.
Where 45382 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$713.82 to $778.71
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $750.94 | $241.05 |
| Miami | $778.71 | $254.72 |
| Rest Of Florida | $713.82 | $232.62 |
How the 45382 rate is calculated
Each of 45382’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 45382
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.54Practice expense 16.82Malpractice 0.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45382
The CMS indicators that decide how 45382 is paid alongside other services.
CMS payment indicators · 45382
Colonoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45382 without 51 · national office
$730.14
Colonoscopy
45382-51 · Second procedure: 50%
$365.07
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
45382 compared with similar codes
Compare codes
45382 vs 45378 vs 45381 vs 45385 vs 45398: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45378Colonoscopy
- 45378 represents diagnostic colonoscopy without therapeutic bleeding control. Use 45382 when the endoscopist treats an identified bleeding source.
- 45381Colonoscopy injection
- 45381 represents submucosal injection, such as for marking or lifting a lesion. Use 45382 when injection is performed to control bleeding.
- 45385Snare polypectomy
- 45385 is for snare removal of a lesion. 45382 is for endoscopic treatment of bleeding, not removal of the bleeding lesion.
- 45398Colonoscopy
- 45398 identifies colonoscopy with band ligation. Use it when band ligation is the documented intervention rather than reporting bleeding control generically.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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