$348.26
45378 represents diagnostic colonoscopy. Choose 45393 when the procedure includes therapeutic decompression of the distended colon.
On this page
CMS RVU26D · Effective 2026-10-01
45393 Colonic decompression Medicare reimbursement rates in Tennessee
Endoscopic colonic decompression relieves acute distention, sometimes with a decompression tube, and is reported when that therapeutic intervention is performed. Compare 45393 office and facility rates across CMS payment localities in Tennessee.
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 45393 in Tennessee?
Tennessee 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
$205.47
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 45393: Colonoscopy with colonic decompression
Endoscopic colonic decompression relieves acute distention, sometimes with a decompression tube, and is reported when that therapeutic intervention is performed.
CPT 45393 represents flexible colonoscopy performed to relieve marked colonic distention by evacuating gas and fluid, with or without leaving a decompression tube. It is used in situations such as acute colonic pseudo-obstruction (Ogilvie syndrome) or selected volvulus cases when endoscopic decompression is chosen. A gastroenterologist or colorectal surgeon typically performs the procedure in a hospital or other endoscopy-capable facility, often for an acutely ill patient.
Report the code when decompression is the therapeutic purpose, not for routine diagnostic inspection alone. Documentation should identify the indication, procedure performed, whether a tube was placed, and the clinical response. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed in the same session, endoscopy-family pricing applies rather than pricing each as an unrelated procedure. Modifier 50 is inappropriate. Medicare does not pay an assistant-at-surgery claim for this procedure; co-surgeons and team surgeons are not permitted.
CMS billing rules for 45393
- 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 RVU4.56 · 70%
- Practice expense (office) RVU1.42 · 22%
- Malpractice RVU0.56 · 9%
2K
Medicare services in 2024 · #2475 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.
45393 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$615.07
45386 is for balloon dilation of a colonic narrowing. It is not the decompression code when the therapeutic objective is relief of colonic distention.
No office rate
45389 represents colonoscopic stent placement. Use 45393 for decompression when a stent is not the intervention performed.
$671.29
45382 is for endoscopic control of bleeding. Use 45393 when colonic decompression, rather than hemostasis, is the therapeutic service.
Compare 45393 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$205.47
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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 45393 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
5,527
- Code
- 45393
- Physician work
- 4.56
- Practice expense
- 1.42
- Malpractice
- 0.56
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.56 | × 1.000 | 4.5600 |
| Practice expense | 1.42 | × 0.909 | 1.2908 |
| Malpractice | 0.56 | × 0.537 | 0.3007 |
| Total RVUs | 6.1515 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$205.47
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.56 | 1 |
| Practice expense | 1.42 | 0.909 |
| Malpractice | 0.56 | 0.537 |
(4.56 × 1 + 1.42 × 0.909 + 0.56 × 0.537) × $33.4009 = $205.47
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.
45393 billing questions
When should 45393 be chosen instead of a diagnostic colonoscopy?
Use 45393 when the colonoscopy is performed therapeutically to decompress the colon, as in acute colonic pseudo-obstruction. A diagnostic examination without decompression is represented by 45378.
Is placement of a decompression tube separately reported?
Tube placement is included in 45393 when performed; the code also covers decompression without leaving a tube.
Can 45378 also be reported for the same procedure?
Do not separately report a diagnostic colonoscopy for the inspection that is part of the decompressive procedure.
How does Medicare price another endoscopy performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together, rather than pricing each as an unrelated full procedure.
Which surgical modifiers are appropriate for this service?
Modifier 50 is inappropriate. Medicare does not pay an assistant-at-surgery claim, and co-surgeon or team-surgery billing is 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.
5,52445390,,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
5,52945397,,Lap remove rectum w/pouch,A,,35.59,16.39,NA,16.39,,6.16,58.14,58.14,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53045398,,Colonoscopy w/band ligation,A,,4.10,22.32,,1.57,,0.60,27.02,6.27,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780