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CPT code 45300: Proctosigmoidoscopy, rigid, diagnostic2026 Medicare rate & RVUs in Los Angeles, CA

Reports rigid-scope examination of the rectum and distal sigmoid for diagnostic evaluation, including brushing or washing specimen collection when performed.

CMS RVU26DEffective Oct 1, 2026One payment locality13.2K Medicare services in 2024

In Los Angeles, CA, Medicare pays $169.88 for 45300 in the office and $47.39 when it’s performed in a hospital or facility.

$169.88Office (non-facility)
$47.39Hospital or facility
+14.3%vs the national office rate ($148.63)

Check a contract rate as a % of Medicare · 45300 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 45300 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 45300 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Los Angeles, CA compares for 45300

Across 109 of 109 payment localities, the office rate for 45300 runs from $129.86 in Arkansas to $201.75 in San Benito County, CA. Los Angeles, CA pays $169.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

45300 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$169.88
  2. Bakersfield, CA · California$158.78−$11.10
  3. Chico, CA · California$158.41−$11.47
  4. El Centro, CA · California$158.43−$11.45
  5. Fresno, CA · California$158.41−$11.47
  6. Hanford, CA · California$158.41−$11.47
  7. Madera, CA · California$158.41−$11.47

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

45300 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$158.41$44.93
Modesto, CACalifornia$158.41$44.93
Napa, CACalifornia$185.74$49.27
Oxnard, CACalifornia$169.25$46.86
Redding, CACalifornia$158.41$44.93
Rest of CaliforniaCalifornia$158.41$44.93
Riverside, CACalifornia$159.82$46.33
Sacramento, CACalifornia$166.83$46.41

45300 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
45300 office rate range by state
State / territoryOffice rate rangeLocalities
AK$167.401
AL$131.971
AR$129.861
AZ$144.341
CA$158.41–$201.7529
CO$155.561
CT$159.171
DC$171.581
DE$146.911
FL$145.62–$160.123
GA$136.70–$151.482
GU$163.001
HI$163.001
IA$135.971
ID$136.891
IL$140.79–$155.364
IN$137.771
KS$135.131
KY$135.141
LA$134.85–$142.252
MA$154.44–$172.162
MD$149.96–$171.583
ME$137.53–$145.972
MI$138.91–$147.472
MN$149.011
MO$132.20–$142.973
MS$131.071
MT$148.631
NC$139.141
ND$146.051
NE$136.831
NH$152.941
NJ$160.98–$169.492
NM$139.691
NV$148.031
NY$141.43–$176.375
OH$138.381
OK$135.011
OR$146.87–$161.062
PA$138.70–$154.792
PR$149.871
RI$152.561
SC$139.001
SD$145.751
TN$135.861
TX$137.68–$155.058
UT$141.101
VA$145.35–$171.582
VI$149.871
VT$145.311
WA$154.20–$175.982
WI$140.661
WV$135.021
WY$147.511

See 45300 in every payment locality

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

Office or facility?

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.

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,487

Code
45300
Physician work
0.78
Practice expense
3.54
Malpractice
0.13

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 45300 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work0.78× 1.0410.8120
Practice expense3.54× 1.1834.1878
Malpractice0.13× 0.6640.0863
Total RVUs5.0861
Conversion factor× 33.4009

Office rate, Los Angeles, CA$169.88

Office: (0.78 × 1.041 + 3.54 × 1.183 + 0.13 × 0.664) × $33.4009 = $169.88

Facility: (0.78 × 1.041 + 0.44 × 1.183 + 0.13 × 0.664) × $33.4009 = $47.39

Open 45300 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician 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%).

When to use modifier 51

Codes related to 45300

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 45300
CodeHow it relatesOffice range, Los Angeles, CA
Same family
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than diagnostic examination alone.$225.93
45303Proctosigmoidoscopy, dilation of a narrowingRigid proctosigmoidoscopy with dilation.$1,202.57
Used instead
45330Flexible sigmoidoscopy, diagnosticDiagnostic examination using a flexible sigmoidoscope instead of a rigid scope.$248.50

How 45300 has changed in Los Angeles, CA

45300 · Office / nonfacility

$169.88

Effective 2026-10-01

The base rate is $26.08 higher than on 2025-10-01, moving from $143.80 to $169.88 (18.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $143.80changed to$169.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.80 changed to 0.78
    • Practice expense RVU 2.95 changed to 3.54
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $146.79changed to$143.80

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.92 changed to 2.95

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $144.39changed to$146.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $149.73changed to$144.39

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.95 changed to 2.92
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $153.07changed to$149.73

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.98 changed to 2.95
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $155.28changed to$153.07

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.99 changed to 2.98
    • Malpractice RVU 0.13 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $143.88changed to$155.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.61 changed to 2.99
    • Malpractice RVU 0.11 changed to 0.13
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $141.15changed to$143.88

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.54 changed to 2.61
    • Malpractice RVU 0.13 changed to 0.11
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $145.66changed to$141.15

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.65 changed to 2.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $142.04changed to$145.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.58 changed to 2.65
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $141.05changed to$142.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.57 changed to 2.58
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $142.90changed to$141.05

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.61 changed to 2.57
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $142.19changed to$142.90

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $139.53changed to$142.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.57 changed to 2.61
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $144.29changed to$139.53

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.89 changed to 2.57
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$144.29

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$169.88$47.39RVU26D
2026-07-01$169.88$47.39RVU26C
2026-04-01$169.88$47.39RVU26B
2026-01-01$169.88$47.39RVU26A
2025-10-01$143.80$50.34RVU25D
2025-07-01$143.80$50.34RVU25C
2025-04-01$143.80$50.34RVU25B
2025-01-01$143.80$50.34RVU25A
2024-10-01$146.79$51.00RVU24D
2024-07-01$146.79$51.00RVU24C
2024-04-01$146.79$51.00RVU24B
2024-03-09$146.79$51.00RVU24AR
2024-01-01$144.39$50.17RVU24A
2023-10-01$149.73$51.75RVU23D
2023-07-01$149.73$51.75RVU23C
2023-04-01$149.73$51.75RVU23B
2023-01-01$149.73$51.75RVU23A
2022-10-01$153.07$51.82RVU22D
2022-07-01$153.07$51.82RVU22C
2022-04-01$153.07$51.82RVU22B
2022-01-01$153.07$51.82RVU22A
2021-10-01$155.28$52.37RVU21D
2021-07-01$155.28$52.37RVU21C
2021-04-01$155.28$52.37RVU21B
2021-01-01$155.28$52.37RVU21A
2020-10-01$143.88$53.05RVU20D
2020-07-01$143.88$53.05RVU20C
2020-04-01$143.88$53.05RVU20B
2020-01-01$143.88$53.05RVU20A
2019-10-01$141.15$53.77RVU19D
2019-07-01$141.15$53.77RVU19C
2019-04-01$141.15$53.77RVU19B
2019-01-01$141.15$53.77RVU19A
2018-10-01$145.66$60.49RVU18D
2018-07-01$145.66$60.49RVU18C
2018-04-01$145.66$60.49RVU18B
2018-01-01$145.66$60.49RVU18AR1
2017-10-01$142.04$60.65RVU17D
2017-07-01$142.04$60.65RVU17C
2017-04-01$142.04$60.65RVU17B
2017-01-01$142.04$60.65RVU17A
2016-10-01$141.05$60.40RVU16D
2016-07-01$141.05$60.40RVU16C
2016-04-01$141.05$60.40RVU16B
2016-01-01$141.05$60.40RVU16A
2015-10-01$142.90$60.71RVU15D
2015-07-01$142.90$60.71RVU15C
2015-04-01$142.19$60.41RVU15B
2015-01-01$142.19$60.41RVU15A
2014-10-01$139.53$59.46RVU14D
2014-07-01$139.53$59.46RVU14C
2014-04-01$139.53$59.46RVU14B
2014-01-01$139.53$59.46RVU14A
2013-10-01$144.29$58.70RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 45300 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

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
RVUs for 45300PPRRVU2026_Oct_nonQPP.csv, line 5,487 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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