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See a sample rate comparisonCPT 45384 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexure Withremoval Of Tumor(S) Polyp(S) Or Other Lesion(S) By Hot Biopsy Forceps Or Bipolar Cautery
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None PT - Colorectal cancer screening test; converted to diagnostic test or other procedure 33 - Preventive Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45384 |
| Medicaid Fee Schedule | View Medicaid rates for 45384 |
National average reimbursement for CPT 45384 by major payers:
$607.77
$625.24
$687.87
$412.54
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CPT 45384
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Azle
$3,607.00Published rateKhs Ambulatory Surgery Center, LLC, Select Surgical Center At Kennedy
Khs Ambulatory Surgery Center LLC
$1,258.00Published rateRattner Vascular Medical Center Asc LLC
$816.00Published rateElmira Asc LLC
$710.00Published rateKingsley Endoscopy Center LLC
$339.00Published rate
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See a sample payer proposalCPT 45384 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45384 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 45384 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 45333-CPT | Moderate | Sigmoidoscopy Flexible With, Sigmoidoscopy Flexible With Removal Of Tumor(S)Polyp(S)Or Other Lesion(S) By Hot Biopsy Forceps Or Bipolar Cautery Sigmoidoscopy Flexible Wit H Removal Of Tumor(S) Polyp(S) |
| 45338-CPT | Moderate | Colonoscopy To Remove Tissue, An Exam Of The Lower Part Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Removes Abnormal Tissue Growths Such As Tumors Or Polyps. |
| 45380-CPT | Moderate | Intestinal Exam (Colonoscopy), An Exam Of The Lower Part Of The Intestine (Colon) Using A Scope (Colonoscopy). The Procedure May Include Collection Of Cells Or Tissue For Testing (Biopsy). |
| 45384-CPT | Moderate | Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexure Withremoval Of Tumor(S) Polyp(S) Or Other Lesion(S) By Hot Biopsy Forceps Or Bipolar Cautery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45384. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45384 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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