CPT 45380

Across 1,249,030 services billed by 16,278 providers to 1,241,593 beneficiaries, Medicare allowed an average of $242.88 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

• 45385Removal of polyps or growths of large bowel$362.33
• 45378Diagnostic exam of large bowel$260.72
• 45384Removal of polyps or growths of large bowel$277.07
• 45381Injection beneath lining of large bowel$181.72
• 45390Removal of large bowel tissue$582.65
• 45330Diagnostic exam of lower portion of large bowel$98.83
• 45388Destruction of polyp or growth of large bowel$491.91
• 45300Diagnostic exam of rectum and lower large bowel$116.96
• 45331Biopsy of lower large bowel$291.11
• 45382Control of bleeding of upper large bowel$290.18
• 45398Banding of hemorrhoids$404.14

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →