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See a sample rate comparisonCPT 45389 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; 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 | None 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45389 |
| Medicaid Fee Schedule | View Medicaid rates for 45389 |
National average reimbursement for CPT 45389 by major payers:
$395.27
$416.67
$427.01
$494.54
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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 CPT 45389 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 45389 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 |
|---|---|---|
| 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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