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CMS October 2026Physician Fee Schedule · Free lookup

CPT 45378 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 45378 is $378.10 in a non-facility setting ($164.67 in a facility), up 15.4% from $327.67 in 2025.

National rate, October 2026
Non-facility
$378.10
Facility
$164.67
vs. 2025
+15.4%
Commercial national avg.
$441.70

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45378
20262025

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Up to 5 codes · 4 remaining

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Physician Fee Schedule·45378·National·2026, 2025
Current non-facility rate
$378.10▼49.9%
Facility: $164.67
Recent trend
Code description

Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression

CodeDateStateLocalityCarrierNon-Facility FeeFacility FeeDescription
4537810/2026N/A0000000$378.10$164.67Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
4537810/2026N/A0000000$189.38$82.50Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453787/2026N/A0000000$378.10$164.67Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453787/2026N/A0000000$189.38$82.50Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453784/2026N/A0000000$189.38$82.50Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453784/2026N/A0000000$378.10$164.67Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453781/2026N/A0000000$189.38$82.50Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453781/2026N/A0000000$378.10$164.67Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
4537810/2025N/A0000000$164.00$88.95Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
4537810/2025N/A0000000$327.67$177.26Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453787/2025N/A0000000$164.00$88.95Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453787/2025N/A0000000$327.67$177.26Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453784/2025N/A0000000$327.67$177.26Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453784/2025N/A0000000$164.00$88.95Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453781/2025N/A0000000$164.00$88.95Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression
453781/2025N/A0000000$327.67$177.26Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression

45378 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS fileNon-facilityFacilityChange
October 2026$378.10$164.67+15.4%
October 2025$327.67$177.26-3.4%
March 2024$339.20$181.42-1.8%
January 2023$345.31$183.67-3.3%
July 2022$357.14$186.87-

This is the national amount before geographic adjustment. Medicare multiplies each relative value unit by its locality's geographic practice cost index, so a practice's own allowed amount can be higher or lower; pick a state above to see its localities. The facility amount applies when the service is performed in a hospital or other facility setting.

45378: Medicare vs. commercial national average

The commercial national average for 45378, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $441.70, 117% of Medicare's $378.10.

  • BCBS $441.56
  • UnitedHealthcare $471.77
  • Aetna $522.30
  • Cigna $331.18

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 45378 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national non-facility amount before geographic adjustment.

Nearby codes

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Medicaid comparison

State Medicaid programs pay a median of $295.28 for 45378

Across 44 state fee schedules the rate runs from $164.22 in NH to $615.29 in AK - a 3.7x spread. That median is 78% of Medicare's $378.098 national non-facility rate. Free to explore state by state.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.