Top billers · Codes · 45380

Who bills 45380?

45380 is the CPT code for: Biopsy of large bowel using a flexible endoscope. In 2024, 16,278 providers billed 45380 1,249,030 times, with an estimated $247.5M paid by Medicare.

$479.97
2026 PFS national rate (office)
16,278
Providers billing it (2024)
1,249,030
Services billed
$247.5M
Est. Medicare paid
The fee

What does Medicare pay for 45380?

Medicare's 2026 Physician Fee Schedule national rate for 45380 is $479.97 in the office setting and $177.69 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$479.97
Facility rate$177.69
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $198.13 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 45380 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1G I Diagnostic And Therapeutic Center LLCAmbulatory Surgical CenterGermantown, TN3,821$1.4M
2Mngi Endoscopy Asc IncAmbulatory Surgical CenterMinneapolis, MN1,993$731K
3Jacksonville Endoscopy Centers LLCAmbulatory Surgical CenterJacksonville, FL1,833$694K
4Voorhees Nj Endoscopy Asc LLCAmbulatory Surgical CenterVoorhees, NJ1,620$642K
5Endoscopy Center Of Santa Maria LLCAmbulatory Surgical CenterSanta Maria, CA1,610$693K

16,273 more providers billed 45380 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

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The breakdown

Where 45380 gets billed.

Top states by volume

California152,175 services
Florida104,542 services
Texas95,399 services
New York78,201 services
New Jersey56,601 services
Pennsylvania55,388 services
Illinois50,762 services
Maryland42,254 services

About this code

CMS descriptionBiopsy of large bowel using a flexible endoscope
Code typeCPT (Level I HCPCS)
Providers billing it (2024)16,278
Services billed (2024)1,249,030
Avg. Medicare payment per service (2024)$198.13
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

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