Billing code 45385: Snare polypectomyMedicare rate & RVUs in Utah
Report 45385 when one or more polyps or other lesions are removed during flexible colonoscopy with a wire snare, with or without cautery.
Medicare pays $478.23 for 45385 in the office in Utah (Utah). 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 45385 covers
During this procedure, a gastroenterologist or colorectal surgeon advances a flexible colonoscope through the colon, typically to the cecum. Polyps or other lesions are captured with a wire snare and removed either cold or with electrocautery. Removed tissue is typically submitted for pathology. Most cases occur in hospital outpatient departments and ambulatory surgery centers, with a smaller share in office endoscopy suites. Common situations include screening colonoscopies that uncover adenomas, surveillance after prior polyps, and evaluation of a positive stool test.
Report one unit per session regardless of how many lesions are snared. The procedure report should identify the removal technique, lesion sites and sizes, exam extent, and bowel prep quality. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing uses diagnostic colonoscopy 45378 as the base to calculate payment for additional procedures. Medicare does not pay an assistant at surgery for 45385; co-surgeons and team surgery are not permitted. Because the colon is not a bilateral structure, modifier 50 is inappropriate.
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.
45385 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $478.23 | $218.27 |
How the 45385 rate is calculated
Each of 45385’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 · 45385
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.46Practice expense 10.00Malpractice 0.51
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45385
The CMS indicators that decide how 45385 is paid alongside other services.
CMS payment indicators · 45385
Snare polypectomy
| 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
45385 without 51 · national office
$500.01
Snare polypectomy
45385-51 · Second procedure: 50%
$250.01
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%).
45385 compared with similar codes
Compare codes
45385 vs 45384 vs 45380 vs 45390 vs 45378: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45384Colonoscopy polyp removal
- 45384 covers lesion removal with hot biopsy forceps or bipolar cautery. Use 45385 when a snare removes the lesion, whether the snare is hot or cold.
- 45380Colonoscopy with biopsy
- 45380 covers biopsy, including cold forceps removal of a small polyp. Use 45385 when a snare removes the lesion; do not report both for the same lesion.
- 45390Colonoscopy
- 45390 applies when documentation supports endoscopic mucosal resection. Injection before snaring, by itself, does not establish that technique; use 45385 for conventional snare removal.
- 45378Colonoscopy
- 45378 covers diagnostic colonoscopy without lesion removal. When a lesion is removed by snare, report 45385 instead of separately reporting the diagnostic exam.
45385 billing questions
How many units are reported when several polyps are removed by snare?
One unit. The code covers all lesions removed by snare during the session, regardless of their number or location.
Can 45380 be reported with 45385 in the same session?
Yes, when a separate lesion is biopsied. Use modifier 59 on 45380 when needed to identify the distinct lesion; a biopsy of the lesion subsequently removed by snare is included in 45385.
What happens when a Medicare screening colonoscopy turns into a polypectomy?
Report 45385 instead of the screening G code and append modifier PT to identify the procedure as a screening that became therapeutic. The Medicare screening-related deductible waiver then applies.
Should 45385 or 45390 be reported when a polyp is lifted with an injection before snaring?
An injection lift alone does not establish endoscopic mucosal resection. Report 45390 when the procedure report supports that resection technique; do not add 45385 or 45381 for the same lesion's resection and lift.
Can a tattoo injection be added to 45385?
A documented submucosal ink injection to mark the polypectomy site may be reported with 45381. When both services are payable, endoscopy family pricing applies.
How do snare and hot biopsy forceps removal differ for coding?
Snare removal, hot or cold, is reported with 45385. Removal with hot biopsy forceps or bipolar cautery is reported with 45384; when different lesions are treated by both methods, a distinct-procedure modifier may be needed.
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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