How much does Medicare pay for CPT 45388?

Medicare allowed an average of $491.91 per service and paid $401.42 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2263.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 45388?

Destruction of polyp or growth of large bowel using a flexible endoscope. It was billed 11,170 times to 11,088 Medicare beneficiaries by 293 providers in 2024.

Does 45388 pay differently in an office than a hospital?

Yes. The allowed amount averaged $2463.44 in an office setting and $340.02 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 45388 most?

Gastroenterology, with 5,310 services from 153 clinicians. Next are Ambulatory Surgical Center, Colorectal Surgery (Proctology), General Surgery.

CPT 45388

Destruction of polyp or growth of large bowel using a flexible endoscope

$491.91Medicare-allowed amount per service, averaged across 11,170 services

Providers submitted

$2263.12

Asking price, not received

Medicare allowed

$491.91

The fee schedule figure

Medicare paid

$401.42

Balance is patient coinsurance

Providers submitted an average of $2263.12 for this code and Medicare allowed $491.91 — 4.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $401.42 (82%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $2463.44
Hospital / facility: $340.02

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 799 services were billed in an office setting and 10,371 in a facility.

Services: 11,170
Beneficiaries: 11,088
Providers billing it: 293
Total allowed: $5,494,635

What Medicare pays for CPT 45388

Across 11,170 services billed by 293 providers to 11,088 beneficiaries, Medicare allowed an average of $491.91 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.

Who bills 45388

Specialty	Services	Beneficiaries	Avg allowed	Providers
Gastroenterology	5,310	5,268	$406.23	153
Ambulatory Surgical Center	2,950	2,937	$558.77	78
Colorectal Surgery (Proctology)	1,255	1,243	$970.57	19
General Surgery	1,159	1,153	$270.00	31
Internal Medicine	446	437	$265.65	8
Family Practice	37	37	$246.05	3
General Practice	13	13	$2354.94	1

45388 reimbursement by state

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.

State	Services	Allowed	Standardized pmt	Providers
California	1,598	$443.45	$323.14	44
Alabama	1,479	$314.13	$280.74	25
Florida	1,115	$439.41	$374.76	32
Arkansas	735	$567.59	$557.18	18
New Hampshire	604	$271.25	$217.26	3
New York	528	$2301.00	$1617.75	12
Michigan	483	$429.43	$350.58	5
Arizona	477	$603.14	$494.67	9
Maryland	437	$366.77	$290.51	5
Texas	398	$394.65	$332.53	15
New Jersey	326	$460.70	$360.60	11
Oregon	285	$381.37	$294.67	4
North Carolina	265	$340.17	$302.33	11
Kentucky	265	$306.64	$265.35	6
Tennessee	222	$273.24	$236.99	8
South Carolina	211	$345.22	$300.86	9
Virginia	204	$425.46	$338.03	8
Washington	170	$251.85	$199.18	7
Ohio	152	$315.69	$279.59	4
Missouri	139	$306.80	$278.02	3
Louisiana	128	$311.26	$276.91	6
Pennsylvania	111	$419.02	$357.31	5
Hawaii	95	$364.23	$266.62	4
Kansas	91	$267.11	$229.14	5
Wisconsin	89	$244.51	$213.83	3
Illinois	87	$686.82	$534.86	4
Mississippi	77	$392.60	$360.68	5
Indiana	62	$321.55	$282.62	4
Delaware	54	$427.13	$336.97	2
Iowa	44	$439.93	$395.94	2
Oklahoma	42	$256.64	$213.42	1
South Dakota	40	$247.97	$217.85	3
District of Columbia	35	$298.05	$204.30	1
North Dakota	30	$422.18	$353.99	2
Georgia	25	$255.97	$212.77	2
Minnesota	18	$587.13	$458.22	1
West Virginia	13	$244.76	$205.37	1
Nevada	13	$2354.94	$1814.60	1
Maine	12	$266.64	$198.65	1
Idaho	11	$1992.70	$1872.16	1

Related codes

45385Removal of polyps or growths of large bowel$362.33
45380Biopsy of large bowel$242.88
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
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

Billing this code is not the same as earning it

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 →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.