Billing code 45390: ColonoscopyMedicare rate & RVUs in Oklahoma
Report this service when a flexible colonoscopy uses endoscopic mucosal resection to remove a colorectal lesion, rather than only sampling or diagnosing it.
CMS doesn’t publish an office rate for 45390 in Oklahoma.
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 45390 covers
A gastroenterologist or colorectal surgeon uses a flexible colonoscope to inspect the colon and remove a mucosal lesion by endoscopic mucosal resection (EMR). EMR commonly involves lifting the target from the underlying tissue and resecting it endoscopically, often with a snare. It is used for colorectal lesions, including flat or sessile lesions, in hospital outpatient departments and ambulatory surgery centers.
Report the service when the documented therapeutic technique is EMR, not simply biopsy, forceps removal, or conventional snare removal. The procedure note should identify the lesion’s location and characteristics and describe the resection technique and findings. 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 claim because of a statutory restriction, and co-surgeon and team-surgery reporting 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.
45390 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $277.73 |
How the 45390 rate is calculated
Each of 45390’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 · 45390
RVUs × geographic indexes × conversion factor
Work5.89
5.89 RVUs× 1.000 GPCI
Practice expense2.15
2.15 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
8.6900
Conversion factor
$33.4009
Medicare rate
$290.25
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45390
The CMS indicators that decide how 45390 is paid alongside other services.
CMS payment indicators · 45390
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
45390 without 51 · national facility
$290.25
Colonoscopy
45390-51 · Second procedure: 50%
$145.13
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%).
45390 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45385Snare polypectomy
- 45390 represents EMR; 45385 represents conventional snare removal. Choose based on the documented resection technique.
- 45384Colonoscopy polyp removal
- 45384 is for lesion removal by hot biopsy forceps or bipolar cautery, rather than EMR.
- 45380Colonoscopy with biopsy
- 45380 is for tissue sampling by biopsy. It does not represent removal of the lesion by EMR.
- 45378Colonoscopy
- 45378 describes diagnostic colonoscopy. When EMR is performed during the examination, the therapeutic service is represented by 45390.
45390 billing questions
How does 45390 differ from colonoscopic snare removal?
45390 is for endoscopic mucosal resection. Use 45385 for conventional snare removal when the documented technique is not EMR.
Can the diagnostic colonoscopy be reported separately?
Do not separately report a diagnostic colonoscopy for the inspection that is part of the same procedure in which the lesion is treated by EMR.
Can submucosal injection be billed separately for the same lesion?
Do not separately report an injection that is part of the EMR technique for the lesion being resected.
What documentation supports 45390?
Document the lesion’s location and characteristics and describe the EMR technique and procedural findings. The record should support that EMR, rather than biopsy or another removal method, was performed.
How are related endoscopies priced when performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The code’s payment is subject to that family pricing.
Which assistant or surgical-team modifiers are appropriate?
Modifier 50 is inappropriate for this service. Medicare does not pay assistant-at-surgery claims for it, 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 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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