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See a sample rate comparisonCPT 45385 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 To Remove Growth, An Exam Of The Intestine Using A Scope (Colonoscopy). The Procedure Includes Removing One Or More Tissue Growths Such As A Tumor Or Polyp.
| 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 33 - Preventive Services PT - Colorectal cancer screening test; converted to diagnostic test or other procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45385 |
| Medicaid Fee Schedule | View Medicaid rates for 45385 |
National average reimbursement for CPT 45385 by major payers:
$594.16
$631.96
$696.85
$459.40
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CPT 45385
5 of 25 sample ratesHigher to lower in this preview
Hongyan Zou
$2,806.57Published rateMichael Rosenband
$978.64Published rateGaetano Bello
$785.97Published rateNina Priven
$642.31Published rateSang K. Han, M.D., F.A.C.S., P.A.
Sang K Han Md Facs PA
$420.23Published rate
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See a sample payer proposalCPT 45385 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45385 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 45385 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 |
|---|---|---|
| 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. |
| 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 |
| 45385-CPT | Moderate | Colonoscopy To Remove Growth, An Exam Of The Intestine Using A Scope (Colonoscopy). The Procedure Includes Removing One Or More Tissue Growths Such As A Tumor Or Polyp. |
| 45390-CPT | Moderate | Colonoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed, With Endoscopic Mucosal Resection |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45385 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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