45391 Colonoscopy with endoscope ultrasound
Also known as: colonoscopy with ultrasound, colon EUS
Colonoscopy with endoscopic ultrasound (EUS) evaluation for assessment of lesions or layer invasion.
In Plain Language
ultrasound imaging during colonoscopy; sound wave assessment of bowel layers
Clinical Context
Used to evaluate depth of invasion of colonic lesions, assess wall layers, guide fine-needle aspiration, or evaluate submucosal pathology.
RVU Breakdown
| Work RVU | 4.52 |
| Total RVU | 4.52 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 0-day global period, meaning pre- and post-operative E&M visits are billable separately on the same day. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 4.52, this code ranks in the 31st percentile among Surgery codes — 1.8x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 45391?
CPT 45391 (Colonoscopy with endoscope ultrasound) is a Surgery code. Colonoscopy with endoscopic ultrasound (EUS) evaluation for assessment of lesions or layer invasion.
What is the wRVU value for CPT 45391?
The work RVU for CPT 45391 is 4.52. This code is primarily used by Colorectal Surgery, Gastroenterology, General Surgery.
When is CPT 45391 used?
Used to evaluate depth of invasion of colonic lesions, assess wall layers, guide fine-needle aspiration, or evaluate submucosal pathology.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.