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See a sample rate comparisonCPT 45390 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 Specimen(S) By Brushing Or Washing, When Performed, With Endoscopic Mucosal Resection
| 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 59 - Distinct Procedural Service PT - Colorectal cancer screening test; converted to diagnostic test or other procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45390 |
| Medicaid Fee Schedule | View Medicaid rates for 45390 |
National average reimbursement for CPT 45390 by major payers:
$469.68
$466.67
$518.95
$569.18
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CPT 45390
5 of 25 sample ratesHigher to lower in this preview
Hamilton Surgery Center L.L.C., Surger Center At Hamilton
Hamilton Surgery Center, LLC
$1,910.00Published rateMentor Surgery Center Ltd
Mentor Surgery Center,Ltd
$959.00Published rateAdvanced Gastroenterology
$780.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$565.00Published rateGastrointestinal Center Of Hialeah, LLC
Gastrointestinal Center Of Hialeah LLC
$380.00Published rate
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See a sample payer proposalCPT 45390 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45390 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 45390 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. |
| 45349-CPT | Moderate | Sigmoidoscopy, Flexible; Diagnostic, Including Collection Of Specimen(S) By Brushing Or Washing, When Performed With Endoscopic Mucosal Resection. |
| 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. |
| 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 45390. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45390 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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