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See a sample rate comparisonCPT 45398 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 Hemorrhoid Band, An Exam Of The Intestine With A Scope (Colonoscopy). The Procedure Includes Stopping The Flow Of Blood To A Hemorrhoid Using A Band.
| 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 33 - Preventive Services PT - Colorectal cancer screening test; converted to diagnostic test or other procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 45398 |
| Medicaid Fee Schedule | View Medicaid rates for 45398 |
National average reimbursement for CPT 45398 by major payers:
$901.19
$1,020.86
$1,030.12
$481.06
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CPT 45398
5 of 25 sample ratesHigher to lower in this preview
Carlos Cesar
Garden State Healthcare Associates, LLC
$2,581.91Published rateAndrea Iannuzzelli
Virtua Medical Group PA
$1,497.91Published rateJose Guillermo Revelo Paiz
Uhs Of Hampton Inc
$760.19Published rateRichard Friedland
Richard J. Friedland, M.D.
$491.58Published rateSpring Matthews-Brown
Azz Medical Associates PC
$132.55Published rate
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See a sample payer proposalCPT 45398 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 45398 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 45398 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 |
|---|---|---|
| 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. |
| 45378-CPT | Moderate | Colonoscopy Flexible Proxima, Colonoscopy Flexible Proximal To Splenic Flexurediagnostic With Or Without Collection Of Specimen(S) By Brushing Or Washing With Or Without Colon Decompression |
| 45398-CPT | Moderate | Colonoscopy Hemorrhoid Band, An Exam Of The Intestine With A Scope (Colonoscopy). The Procedure Includes Stopping The Flow Of Blood To A Hemorrhoid Using A Band. |
| 45400-CPT | High | Laparoscopy Surgical Proctopexy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 45398. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 45398 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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