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See a sample rate comparisonCPT 45389 Fee Schedule
Medicare rates as of October 2026
CPT 45389 is classified under Surgery, in the Surgical Procedures on the Digestive System subgroup.
Colonoscopy, Flexible; Diagnostic, Including Collection Of Specimens By Brushing Or Washing, When Performed, With Endoscopic Stent Placement Includes Pre And Post Dilation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $253.18 national non-facility rate (2026) · View Medicare rates for 45389 |
| Medicaid Fee Schedule | $205.93 median of the 8 states in the free preview · View Medicaid rates for 45389 |
National average reimbursement for CPT 45389 by major payers:
$395.27
BCBS / Anthem
$416.67
UnitedHealthcare
$427.01
Aetna
$494.54
Cigna
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CPT 45389
5 of 25 sample ratesHigher to lower in this preview
Hacienda Surgery Center, LLC
$2,670.00Published rateNorth Jersey Gastroenterology & Endoscopy Center P.A.
North Jersey Gastroenterology Endoscopy Center PA
$1,666.00Published rateYuma Advanced Surgical Suites LLC
Yuma Advanced Surgical Suites, LLC
$1,233.00Published rateThe Eastside Endoscopy Center LLC
$789.00Published rateFlorida Specialty Surgery Center LLC
$350.00Published rate
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See a sample payer proposalCPT 45389 vs. Other Surgical Procedures on the Digestive System Codes
The table lists codes related to 45389. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 45327-CPT | Low | Large Intestine Scope Exam, Exam Of The Large Intestine (Colon) Using A Scope (Sigmoidoscopy). The Procedure Implants A Support Device (Stent). |
| 45342-CPT | Moderate | Biopsy Of Large Intestine, An Exam Of The Lower Portion Of The Large Intestine Using A Scope (Sigmoidoscopy). The Procedure May Use Ultrasound (Sound Wave Images) To Guide Removal Of A Sample Of Tissue For Testing (Biopsy). |
| 45350-CPT | Moderate | Treatment For Hemorrhoid, Procedure On The Intestine With A Scope (Sigmoidoscopy). It Includes Applying A Small Band To The Base Of The Hemorrhoid Which Stops The Flow Of Blood. |
| 45389-CPT | Moderate | Colonoscopy, Flexible; Diagnostic, Including Collection Of Specimens By Brushing Or Washing, When Performed, With Endoscopic Stent Placement Includes Pre And Post Dilation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45389. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45389 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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