CPT
43239 — Upper GI endoscopy with biopsy
High-volume procedure with predictable surprise-bill risk.
Gastroenterology
45385 — Colonoscopy, flexible, with removal of tumor/polyp/lesion by snare technique
This code covers a colonoscopy in which one or more polyps or tumors are removed using a wire snare loop that encircles the polyp and cuts it off.
- Typical setting: Endoscopy suite, hospital
- National avg charge (illustrative): $350-$700 Medicare allowed for professional fee (commercial payer averages: $594 BCBS, $632 UHC, $697 Aetna, $762 Cigna nationally per PayerPrice 2026)
- Most-disputed reason: Billing multiple units for same technique: if three polyps are all removed by snare technique, 45385 is billed only once — multiple units of the same technique code in one session will be denied
What it means
What 45385 actually means
This code covers a colonoscopy in which one or more polyps or tumors are removed using a wire snare loop that encircles the polyp and cuts it off. This is one of the most common colonoscopy codes when polyps are found. Even if multiple polyps are removed by the same technique, this code is only billed once per session.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing multiple units for same technique: if three polyps are all removed by snare technique, 45385 is billed only once — multiple units of the same technique code in one session will be denied
- Billing both 45380 and 45385 for the same polyp: if a polyp was biopsied and then removed, only the removal code (45385) applies for that lesion
- Screening conversion modifier omission: failing to append modifier -PT (Medicare) or -33 (commercial) when a screening colonoscopy is converted to therapeutic upon finding polyps — this can cause the patient to be billed incorrectly for the deductible
If you see 45385 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 45385 often also see these adjacent codes on the same bill.
CPT
43644 — Laparoscopic Roux-en-Y gastric bypass with small intestine reconstruction
Verify the code matches the actual service and dose.
CPT
45378 — Diagnostic colonoscopy
If your screening colonoscopy turned diagnostic, federal rules limit your cost-share.
CPT
45380 — Colonoscopy, flexible, with biopsy, single or multiple
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 45385 on a bill.
45385 FAQ
Plain-English answers.
What does 45385 usually cost?
$350-$700 Medicare allowed for professional fee (commercial payer averages: $594 BCBS, $632 UHC, $697 Aetna, $762 Cigna nationally per PayerPrice 2026). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 45385?
Billing multiple units for same technique: if three polyps are all removed by snare technique, 45385 is billed only once — multiple units of the same technique code in one session will be denied
What should I do if I see 45385 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 45385 before paying.
Don't pay 45385 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.