$538.60
45384 is for removal with hot biopsy forceps or bipolar cautery; 45385 is for removal by snare.
On this page
CMS RVU26D · Effective 2026-10-01
45384 Colonoscopy polyp removal Medicare reimbursement rates in Hawaii
Reports colonoscopic removal of a polyp or other lesion using hot biopsy forceps or bipolar cautery during a flexible colonoscopy. Compare 45384 office and facility rates across CMS payment localities in Hawaii.
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 45384 in Hawaii?
Hawaii 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
$583.79
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$201.74
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Gastroenterology
About 45384: Colonoscopy lesion removal with cautery
Reports colonoscopic removal of a polyp or other lesion using hot biopsy forceps or bipolar cautery during a flexible colonoscopy.
During flexible colonoscopy, the endoscopist removes a polyp or other lesion using hot biopsy forceps or bipolar cautery. Gastroenterologists and colorectal surgeons commonly perform this in an endoscopy center or hospital outpatient department; it may also be performed in an appropriately equipped office. For example, a polyp treated with cautery during the examination is reported by the removal method, not as a diagnostic-only examination.
Select this code when the documented removal technique is hot biopsy forceps or bipolar cautery; a snare removal is reported with a different code. The procedure note should identify the lesion and document the technique used. The diagnostic examination is part of the therapeutic colonoscopy, rather than a separate diagnostic service for that same examination. This minor procedure 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. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 45384
- 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 RVU3.97 · 25%
- Practice expense (office) RVU11.57 · 72%
- Malpractice RVU0.61 · 4%
46.4K
Medicare services in 2024 · #809 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.
45384 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$522.02
45380 reports colonoscopic biopsy sampling. Choose 45384 when the lesion is removed using hot biopsy forceps or bipolar cautery.
No office rate
45390 is used for endoscopic resection rather than the cautery removal technique represented by 45384.
$407.70
45378 describes a diagnostic colonoscopy without therapeutic lesion removal; when the examination includes removal under 45384, the diagnostic inspection is included.
Compare 45384 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
Hawaii, Guam →
Office / nonfacility
$583.79
Facility
$201.74
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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 45384 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,519
- Code
- 45384
- Physician work
- 3.97
- Practice expense
- 11.57
- Malpractice
- 0.61
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.97 | × 1.000 | 3.9700 |
| Practice expense | 11.57 | × 1.137 | 13.1551 |
| Malpractice | 0.61 | × 0.579 | 0.3532 |
| Total RVUs | 17.4783 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$583.79
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.97 | 1 |
| Practice expense | 11.57 | 1.137 |
| Malpractice | 0.61 | 0.579 |
(3.97 × 1 + 11.57 × 1.137 + 0.61 × 0.579) × $33.4009 = $583.79
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.97 | 1 |
| Practice expense | 1.51 | 1.137 |
| Malpractice | 0.61 | 0.579 |
(3.97 × 1 + 1.51 × 1.137 + 0.61 × 0.579) × $33.4009 = $201.74
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.
45384 billing questions
When should 45384 be chosen over 45385?
Use 45384 when the lesion is removed with hot biopsy forceps or bipolar cautery. Use 45385 when the documented removal method is a snare.
Can the diagnostic colonoscopy also be reported?
The diagnostic inspection is included when the colonoscopy proceeds to lesion removal during the same examination. Do not separately report 45378 for that same examination.
How does 45384 differ from a colonoscopy biopsy?
45384 represents lesion removal by cautery technique. Use 45380 when the service is tissue sampling by biopsy rather than removal using the 45384 technique.
What documentation supports reporting 45384?
The procedure note should identify the lesion and state that hot biopsy forceps or bipolar cautery was used to remove it. The documented technique distinguishes this code from snare removal.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing 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.
5,51645380,,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
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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014