Billing code 45388: Colonoscopy ablationMedicare rate & RVUs in Oklahoma
Reports colonoscopic destruction of a tumor, polyp, or other lesion, such as residual adenomatous tissue treated with endoscopic energy.
Medicare pays $2,389.51 for 45388 in the office in Oklahoma (Oklahoma). 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 45388 covers
A gastroenterologist or colorectal surgeon uses a flexible colonoscope to destroy lesion tissue rather than remove it as a specimen. Ablation may use methods such as argon plasma coagulation or electrocautery. A typical situation is treating residual adenomatous tissue at a prior polypectomy site; the code also covers ablation of other appropriate colonic lesions. The service is performed in settings where colonoscopy is provided, including hospital outpatient departments and ambulatory surgery centers.
Report the code when lesion destruction is performed, and document the lesion treated and the ablation method. When related endoscopies are performed together, CMS applies endoscopy-family pricing. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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.
45388 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $2,389.51 | $227.65 |
How the 45388 rate is calculated
Each of 45388’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 · 45388
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.76Practice expense 74.26Malpractice 0.60
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45388
The CMS indicators that decide how 45388 is paid alongside other services.
CMS payment indicators · 45388
Colonoscopy ablation
| 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
45388 without 51 · national office
$2,659.38
Colonoscopy ablation
45388-51 · Second procedure: 50%
$1,329.69
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%).
45388 compared with similar codes
Compare codes
45388 vs 45384 vs 45385 vs 45382 vs 45346: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45384Colonoscopy polyp removal
- Use 45384 when hot biopsy forceps or bipolar cautery removes lesion tissue. Use 45388 when the treatment destroys the lesion rather than removing it.
- 45385Snare polypectomy
- Use 45385 for snare removal of a lesion. Ablation without snare excision is reported with 45388.
- 45382Colonoscopy
- Use 45382 when the service is directed at controlling bleeding. Use 45388 when the intent is to ablate a tumor, polyp, or other lesion.
- 45346Flexible sigmoidoscopy
- Both codes describe endoscopic lesion ablation; 45346 is for flexible sigmoidoscopy, while 45388 is for colonoscopy.
45388 billing questions
How is ablation different from lesion removal?
Ablation destroys lesion tissue; removal techniques such as forceps or snare excision take tissue out. Choose the code that matches the technique documented.
Can diagnostic colonoscopy be reported separately?
Do not separately report a diagnostic colonoscopy for the same examination when lesion ablation is performed. The diagnostic inspection is part of the therapeutic colonoscopy.
Should modifier 50 be appended for treatment on both sides of the colon?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included. Care on a later date is outside this 0-day global period.
How are related endoscopies priced when performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed in the same session.
Can an assistant surgeon or co-surgeon be reported?
Medicare 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 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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