Endoscopy

45385 - RVUs & Medicare payment (2026)

Colonoscopy with snare polypectomy.

Component	Non-facility	Facility
Work RVU	4.46	4.46
Practice expense RVU	10.00	1.72
Malpractice RVU	0.51	0.51
Total RVUs	14.97	6.69
National payment (CF $33.4009)	$500.01	$223.45
Qualifying APM payment (CF $33.5675)	$502.51	$224.57

How 45385 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 45385 ranges from $444.65 in Arkansas (AR) to $656.13 in San Jose-Sunnyvale-Santa Clara (CA); calculate 45385 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $656.13 San Jose-Sunnyvale-Santa Clara (CA) $653.76 San Francisco-Oakland-Berkeley (CA) $641.89 San Francisco-Oakland-Berkeley (CA) $641.31 Napa (CA) $607.23 Vallejo (CA) $606.40 Alaska (AK) $588.56 NYC Suburbs/Long Island (NY) $587.27 National average $500.01 … 97 more localities between … Rest Of Missouri (MO) $453.48 Alabama (AL) $450.87 Mississippi (MS) $449.14 Arkansas (AR) $444.65

Non-facility payment for 45385 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: 000

Same-day global period: related visits on the day of the procedure are included in the payment.

Related codes - endoscopy

43239 · upper gi endoscopy with biopsy
45378 · colonoscopy, diagnostic
45380 · colonoscopy with biopsy
G0121 · screening colonoscopy, not high risk (medicare)
G0105 · screening colonoscopy, high risk (medicare)
52000 · cystourethroscopy, diagnostic

Frequently asked questions

How much does Medicare pay for 45385 in 2026?

The national non-facility payment is $500.01 and the facility payment is $223.45, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 45385?

The 2026 work RVU for 45385 is 4.46. Total RVUs are 14.97 in the non-facility setting and 6.69 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.