CPT 45388 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 45388 |
National average reimbursement for CPT 45388 by major payers:
$2,357.42
$2,725.34
$3,186.72
$3,692.87
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 45388 | ||||||
United | 45388 | $963.00 | 1619614963 - VALLEY SURGERY CENTER LLC | 873516980 - (WI) VALLEY SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $1011.00 | 1063593952 - CONNECTICUT GI ENDOSCOPY CENTER LLC | 61573358 - (CT) CONNECTICUT GI ENDOSCOPY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $1438.00 | 1942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC | 823193901 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $618.00 | 1740787068 - CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION), CLEVELAND CLINIC FLORIDA CORAL SPRINGS ASC | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $565.00 | 1306134838 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $1258.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $721.00 | 1043680440 - SOUTHWEST MEDICAL ASSOCIATES, INC, SOUTHWEST MEDICAL ASSOCIATES - TENAYA | 880201420 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $2307.00 | 1992395388 - IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CENTER LLC, IU HEALTH SURGERY CENTER FORT WAYNE | 842206388 - (IN) IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $458.00 | 1235112814 - MT PLEASANT SURGICAL CENTER, LLC, MT PLEASANT SURGICAL CENTER | 752691365 - (TX) MT PLEASANT SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $3513.00 | 1477552768 - COURT STREET SURGERY CENTER, LP | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $651.00 | 1174615702 - I CARE CENTER LLC, CENTRAL INDIANA SURGERY CENTER | 351937200 - (IN) ICARE CENTER DBA CENTRAL INDIANA SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $1525.00 | 1396896684 - DREYER AMBULATORY SURGERY CENTER, LLC | 363890298 - (IL) DREYER AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $825.00 | 1174005235 - IDAHO FALLS ASC | 823089090 - (ID) IDAHO FALLS ASC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $1212.00 | 1164561064 - HUNTERDON CENTER FOR SURGERY, LLC, SURGERY TODAY | 223401213 - (NJ) HUNTERDON CENTER FOR SURGERY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 45388 | $945.00 | 1164012142 - COMPREHENSIVE DIGESTIVE SURGICENTER, LLC, COMPREHENSIVE DIGESTIVE SURGICAL CENTER | 854015524 - (NV) COMPREHENSIVE DIGESTIVE SURGICENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 45388 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45388 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 45388 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 |
|---|---|---|
| 45346-CPT | High | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Ablation Of Tumor(S), Polyp(S), Or Other Lesions(S) Includ |
| 45378-CPT | Moderate | Colonoscopy Flexible Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Separate Procedure) (Desc Revised 01/01/15) |
| 45380-CPT | Moderate | Colonoscopy, Fiberoptic, Beyond Splenic Flexure; For Biopsy And/Or Collection Of Specimen By Brushing Or Washing |
| 45388-CPT | High | Colonoscopy, Flexible; Diagnostic, Including Collection Of Specimens By Brushing Or Washing, When Performed, With Ablation Of Tumors, Polyss, Or Other Lesionss Includ |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45388. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45388 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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