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See a sample rate comparisonCPT 45392 Fee Schedule
Last Verified: October 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 W Endoscopic Fnb, Colonoscopy Flexible With Transendoscopic Ultrasound Guided Intramural Or Transmural Fine Needle Aspiration Biopsy S Includes Endoscopic Ultrasound Examination Limited To The Rectum Sigmoid Descending Transverse Or Ascending Colon And Cecum And Adjacent Structures
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None UB PT - Colorectal cancer screening test; converted to diagnostic test or other procedure AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45392 |
| Medicaid Fee Schedule | View Medicaid rates for 45392 |
National average reimbursement for CPT 45392 by major payers:
$441.71
$445.11
$456.97
$531.83
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CPT 45392
5 of 25 sample ratesHigher to lower in this preview
Summit Orthopedics, Ltd, Plymouth Surgery Center
Summit Orthopedics, Ltd.
$2,701.00Published rateMetro Surgery Center, LLC, Metro Surgery Center, Lp
Metro Surgery Center LLC
$1,258.00Published rateThe Surgical Center For Excellence, Lllp
Surgical Center For Excellence, Lllp
$750.00Published rateInnovative Surgery Center, LLC
Innovative Surgery Center LLC
$553.00Published rateApollo Surgery Center LLC
$296.00Published rate
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See a sample payer proposalCPT 45392 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45392 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 45392 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 |
|---|---|---|
| 45341-CPT | Low | Sigmoidoscopy Flexible Diagn, Sigmoidoscopy Flexible Diagnostic With Or Woutcollection Of Specimen(S) By Brushing Or Washing (Separate Procedure) With Endoscopic Ultrasound Examination. |
| 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). |
| 45391-CPT | Moderate | Colonoscopy W Endoscope Us, Colonoscopy Flexible With Endoscopic Ultrasound Examination Limited To The Rectum Sigmoid Descending Transverse Or Ascending Colon And Cecum And Adjacent Structures |
| 45392-CPT | Moderate | Colonoscopy W Endoscopic Fnb, Colonoscopy Flexible With Transendoscopic Ultrasound Guided Intramural Or Transmural Fine Needle Aspiration Biopsy S Includes Endoscopic Ultrasound Examination Limited To The Rectum Sigmoid Descending Transverse Or Ascending Colon And Cecum And Adjacent Structures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45392. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45392 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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