What is the standard insurance baseline for CPT 45384?

The standard insurance baseline reimbursement rate is $195.62. This represents the customary allowable amount established across standard fee schedules.

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CPT 45384Medical Service

Removal of Polyps or Growths of Large Bowel using a Flexible Endoscope with Electrical Cautery

Q: What do doctors typically charge for Removal of Polyps or Growths of Large Bowel using a Flexible Endoscope with Electrical Cautery?

The nationwide median physician charge for Removal of Polyps or Growths of Large Bowel using a Flexible Endoscope with Electrical Cautery (CPT 45384) is $1184.72. Doctor billed charges vary based on geographic region, setting, and overhead.

Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery. Clinical pricing breakdown and utilization metrics across 929 practicing doctors nationwide.

$1184.72

Peer Median Charge

Gross billed rate

$195.62

Standard Baseline

Customary allowable

6.1x

National Markup

Charge vs baseline

929

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $1184.72. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $195.62 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 45384 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"