CPT code 45300: Proctosigmoidoscopy, rigid, diagnostic2026 Medicare rate & RVUs
Reports rigid-scope examination of the rectum and distal sigmoid for diagnostic evaluation, including brushing or washing specimen collection when performed.
Medicare pays $148.63 for 45300 nationally in the office and $45.09 in a hospital or facility. Local office rates run $129.86–$201.75.
Medicare rate · 45300
Proctosigmoidoscopy, rigid, diagnostic
- Work RVUs
- 0.78
- Total RVUs
- 4.45
- Global days
- 000
National rate · 2026
$148.63
Office setting, before claim adjustments.
See every locality for 45300 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 10 sections
What 45300 covers
A physician passes a rigid scope through the anus to examine the rectum and distal sigmoid, commonly to evaluate rectal bleeding, pain, or a suspected distal lesion. Brushing or washing to collect specimens is included when performed. Gastroenterologists and colorectal surgeons may perform the examination in an office or facility setting.
Select this code for a diagnostic rigid examination; a documented biopsy or therapeutic maneuver may call for a different procedure code. The report should identify the indication, examination findings, and any brushing or washing performed. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 45300 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$129.86 to $201.75
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $131.97 | $41.37 |
| Alaska | $167.40 | $57.12 |
| Arizona | $144.34 | $44.01 |
| Arkansas | $129.86 | $40.91 |
| Atlanta, GA | $151.48 | $46.28 |
| Austin, TX | $155.05 | $45.50 |
| Bakersfield, CA | $158.78 | $45.30 |
| Baltimore area, MD | $158.71 | $47.61 |
| Beaumont, TX | $137.68 | $43.46 |
| Brazoria, TX | $146.82 | $44.21 |
| Chicago, IL | $155.03 | $50.97 |
| Chico, CA | $158.41 | $44.93 |
| Colorado | $155.56 | $45.39 |
| Connecticut | $159.17 | $47.66 |
| Dallas, TX | $147.78 | $44.65 |
| Delaware | $146.91 | $44.61 |
| Detroit, MI | $147.47 | $47.56 |
| East St. Louis, IL | $143.58 | $48.32 |
| El Centro, CA | $158.43 | $44.95 |
| Fort Lauderdale, FL | $153.68 | $48.79 |
| Fort Worth, TX | $146.65 | $44.56 |
| Fresno, CA | $158.41 | $44.93 |
| Galveston, TX | $147.27 | $44.45 |
| Hanford, CA | $158.41 | $44.93 |
| Hawaii, Guam, HI | $163.00 | $45.28 |
| Houston, TX | $149.65 | $46.83 |
| Idaho | $136.89 | $41.63 |
| Indiana | $137.77 | $41.79 |
| Iowa | $135.97 | $41.22 |
| Kansas | $135.13 | $41.53 |
| Kentucky | $135.14 | $43.09 |
| King County, WA | $175.98 | $48.94 |
| Los Angeles, CA | $169.88 | $47.39 |
| Madera, CA | $158.41 | $44.93 |
| Manhattan, NY | $172.00 | $51.68 |
| Marin County, CA | $197.24 | $51.24 |
| Merced, CA | $158.41 | $44.93 |
| Metropolitan Boston, MA | $172.16 | $48.53 |
| Metropolitan Kansas City, MO | $141.32 | $44.09 |
| Metropolitan Philadelphia, PA | $154.79 | $47.00 |
| Metropolitan St. Louis, MO | $142.97 | $44.39 |
| Miami, FL | $160.12 | $52.33 |
| Minnesota | $149.01 | $42.46 |
| Mississippi | $131.07 | $41.92 |
| Modesto, CA | $158.41 | $44.93 |
| Montana | $148.63 | $45.08 |
| Napa, CA | $185.74 | $49.27 |
| Nebraska | $136.83 | $41.26 |
| Nevada | $148.03 | $44.38 |
| New Hampshire | $152.94 | $45.15 |
| New Mexico | $139.69 | $44.74 |
| New Orleans, LA | $142.25 | $44.81 |
| North Carolina | $139.14 | $42.54 |
| North Dakota | $146.05 | $42.51 |
| Northern New Jersey | $169.49 | $49.38 |
| NYC suburbs and Long Island, NY | $176.37 | $53.26 |
| Ohio | $138.38 | $43.85 |
| Oklahoma | $135.01 | $42.55 |
| Oxnard, CA | $169.25 | $46.86 |
| Portland, OR | $161.06 | $46.03 |
| Poughkeepsie and northern NYC suburbs, NY | $161.95 | $48.57 |
| Puerto Rico | $149.87 | $45.19 |
| Queens, NY | $173.74 | $51.35 |
| Redding, CA | $158.41 | $44.93 |
| Rest of California | $158.41 | $44.93 |
| Rest of Florida | $145.62 | $46.63 |
| Rest of Georgia | $136.70 | $44.34 |
| Rest of Illinois | $140.79 | $46.26 |
| Rest of Louisiana | $134.85 | $43.22 |
| Rest of Maine | $137.53 | $42.27 |
| Rest of Maryland | $149.96 | $45.17 |
| Rest of Massachusetts | $154.44 | $45.41 |
| Rest of Michigan | $138.91 | $44.37 |
| Rest of Missouri | $132.20 | $42.95 |
| Rest of New Jersey | $160.98 | $47.91 |
| Rest of New York | $141.43 | $43.07 |
| Rest of Oregon | $146.87 | $43.74 |
| Rest of Pennsylvania | $138.70 | $43.65 |
| Rest of Texas | $142.18 | $43.92 |
| Rest of Washington | $154.20 | $45.17 |
| Rhode Island | $152.56 | $45.60 |
| Riverside, CA | $159.82 | $46.33 |
| Sacramento, CA | $166.83 | $46.41 |
| Salinas, CA | $166.23 | $46.22 |
| San Benito County, CA | $201.75 | $52.44 |
| San Diego, CA | $170.60 | $46.76 |
| San Francisco, CA | $197.09 | $51.10 |
| San Luis Obispo, CA | $163.50 | $45.56 |
| Santa Clara County, CA | $201.14 | $51.83 |
| Santa Cruz, CA | $172.59 | $46.78 |
| Santa Maria, CA | $166.98 | $46.25 |
| Santa Rosa, CA | $174.36 | $47.21 |
| South Carolina | $139.00 | $43.32 |
| South Dakota | $145.75 | $42.21 |
| Southern Maine, ME | $145.97 | $43.36 |
| Stockton, CA | $158.41 | $44.93 |
| Suburban Chicago, IL | $155.36 | $49.02 |
| Tennessee | $135.86 | $41.74 |
| Utah | $141.10 | $43.77 |
| Vallejo, CA | $185.53 | $49.06 |
| Vermont | $145.31 | $42.80 |
| Virgin Islands, VI | $149.87 | $45.19 |
| Virginia | $145.35 | $43.56 |
| Visalia, CA | $158.41 | $44.93 |
| Washington, DC area | $171.58 | $49.60 |
| West Virginia | $135.02 | $45.04 |
| Wisconsin | $140.66 | $41.47 |
| Wyoming | $147.51 | $43.96 |
| Yuba City, CA | $158.41 | $44.93 |
45300 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$129.86
$180.08
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $167.40 | 1 |
| AL | $131.97 | 1 |
| AR | $129.86 | 1 |
| AZ | $144.34 | 1 |
| CA | $158.41–$201.75 | 29 |
| CO | $155.56 | 1 |
| CT | $159.17 | 1 |
| DC | $171.58 | 1 |
| DE | $146.91 | 1 |
| FL | $145.62–$160.12 | 3 |
| GA | $136.70–$151.48 | 2 |
| GU | $163.00 | 1 |
| HI | $163.00 | 1 |
| IA | $135.97 | 1 |
| ID | $136.89 | 1 |
| IL | $140.79–$155.36 | 4 |
| IN | $137.77 | 1 |
| KS | $135.13 | 1 |
| KY | $135.14 | 1 |
| LA | $134.85–$142.25 | 2 |
| MA | $154.44–$172.16 | 2 |
| MD | $149.96–$171.58 | 3 |
| ME | $137.53–$145.97 | 2 |
| MI | $138.91–$147.47 | 2 |
| MN | $149.01 | 1 |
| MO | $132.20–$142.97 | 3 |
| MS | $131.07 | 1 |
| MT | $148.63 | 1 |
| NC | $139.14 | 1 |
| ND | $146.05 | 1 |
| NE | $136.83 | 1 |
| NH | $152.94 | 1 |
| NJ | $160.98–$169.49 | 2 |
| NM | $139.69 | 1 |
| NV | $148.03 | 1 |
| NY | $141.43–$176.37 | 5 |
| OH | $138.38 | 1 |
| OK | $135.01 | 1 |
| OR | $146.87–$161.06 | 2 |
| PA | $138.70–$154.79 | 2 |
| PR | $149.87 | 1 |
| RI | $152.56 | 1 |
| SC | $139.00 | 1 |
| SD | $145.75 | 1 |
| TN | $135.86 | 1 |
| TX | $137.68–$155.05 | 8 |
| UT | $141.10 | 1 |
| VA | $145.35–$171.58 | 2 |
| VI | $149.87 | 1 |
| VT | $145.31 | 1 |
| WA | $154.20–$175.98 | 2 |
| WI | $140.66 | 1 |
| WV | $135.02 | 1 |
| WY | $147.51 | 1 |
How the 45300 rate is calculated
Each of 45300’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 45300
RVUs × geographic indexes × conversion factor
Work0.78
0.78 RVUs× 1.000 GPCI
Practice expense3.54
3.54 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
4.4500
Conversion factor
$33.4009
Medicare rate
$148.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45300
The CMS indicators that decide how 45300 is paid alongside other services.
CMS payment indicators · 45300
Proctosigmoidoscopy, rigid, diagnostic
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45300 without 51 · national office
$148.63
Proctosigmoidoscopy, rigid, diagnostic
45300-51 · Second procedure: 50%
$74.32
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
45300 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45330Flexible sigmoidoscopyDiagnostic
- 45300 describes diagnostic examination with a rigid scope; 45330 is the diagnostic flexible sigmoidoscopy code.
- 45305ProctosigmoidoscopyRigid scope with biopsy
- Use 45305 when the rigid examination includes biopsy; 45300 covers diagnostic examination, including brushing or washing when performed.
- 45331SigmoidoscopyWith biopsy
- 45331 describes flexible sigmoidoscopy with biopsy. Distinguish it from rigid examination with biopsy, reported with 45305.
45300 billing questions
How does 45300 differ from diagnostic flexible sigmoidoscopy?
45300 is for examination with a rigid scope. Use 45330 when the examination is performed with a flexible sigmoidoscope.
Can brushing or washing be reported separately?
No. Brushing or washing specimen collection is included in 45300 when performed.
Can a biopsy be reported as 45300?
No. A biopsy is a distinct service; 45305 describes rigid proctosigmoidoscopy with biopsy.
What should the procedure note support?
Document the diagnostic indication, rigid scope examination and findings, and whether brushing or washing was performed.
How does the multiple-procedure rule affect payment?
For procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 45300 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet