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CPT code 45300: Proctosigmoidoscopy, rigid, diagnostic2026 Medicare rate & RVUs in Washington, DC area

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 Washington, DC area, Medicare pays $171.58 for 45300 in the office and $49.60 when it’s performed in a hospital or facility.

$171.58Office (non-facility)
$49.60Hospital or facility
+15.4%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 Washington, DC area
  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 Washington, DC area 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. Washington, DC area pays $171.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

45300 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$171.58
  2. Los Angeles, CA · California$169.88−$1.70
  3. Miami, FL · Florida$160.12−$11.46
  4. Chicago, IL · Illinois$155.03−$16.55
  5. Manhattan, NY · New York$172.00+$0.42
  6. Alaska · Alaska$167.40−$4.18
  7. Alabama · Alabama$131.97−$39.61

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

45300 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$129.86$40.91
ArizonaArizona$144.34$44.01
Bakersfield, CACalifornia$158.78$45.30
Chico, CACalifornia$158.41$44.93
El Centro, CACalifornia$158.43$44.95
Fresno, CACalifornia$158.41$44.93
Hanford, CACalifornia$158.41$44.93
Madera, CACalifornia$158.41$44.93

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 45300 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.78× 1.0540.8221
Practice expense3.54× 1.1784.1701
Malpractice0.13× 1.1130.1447
Total RVUs5.1369
Conversion factor× 33.4009

Office rate, Washington, DC area$171.58

Office: (0.78 × 1.054 + 3.54 × 1.178 + 0.13 × 1.113) × $33.4009 = $171.58

Facility: (0.78 × 1.054 + 0.44 × 1.178 + 0.13 × 1.113) × $33.4009 = $49.60

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, Washington, DC area
Same family
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than diagnostic examination alone.$228.64
45303Proctosigmoidoscopy, dilation of a narrowingRigid proctosigmoidoscopy with dilation.$1,201.76
Used instead
45330Flexible sigmoidoscopy, diagnosticDiagnostic examination using a flexible sigmoidoscope instead of a rigid scope.$249.73

How 45300 has changed in Washington, DC area

45300 · Office / nonfacility

$171.58

Effective 2026-10-01

The base rate is $25.57 higher than on 2025-10-01, moving from $146.01 to $171.58 (17.5%).

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

    $146.01changed to$171.58

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $149.06changed to$146.01

    • 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

    $146.63changed to$149.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $154.99changed to$146.63

    • 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 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $161.57changed to$154.99

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $164.24changed to$161.57

    • 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

    $150.37changed to$164.24

    • 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 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $146.34changed to$150.37

    • 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 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $150.95changed to$146.34

    • 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

    $147.59changed to$150.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.58 changed to 2.65
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $146.94changed to$147.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.57 changed to 2.58
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $148.74changed to$146.94

    • 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

    $148.00changed to$148.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $145.50changed to$148.00

    • 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 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $150.96changed to$145.50

    • 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 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $150.96

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$171.58$49.60RVU26D
2026-07-01$171.58$49.60RVU26C
2026-04-01$171.58$49.60RVU26B
2026-01-01$171.58$49.60RVU26A
2025-10-01$146.01$52.70RVU25D
2025-07-01$146.01$52.70RVU25C
2025-04-01$146.01$52.70RVU25B
2025-01-01$146.01$52.70RVU25A
2024-10-01$149.06$53.44RVU24D
2024-07-01$149.06$53.44RVU24C
2024-04-01$149.06$53.44RVU24B
2024-03-09$149.06$53.44RVU24AR
2024-01-01$146.63$52.57RVU24A
2023-10-01$154.99$54.61RVU23D
2023-07-01$154.99$54.61RVU23C
2023-04-01$154.99$54.61RVU23B
2023-01-01$154.99$54.61RVU23A
2022-10-01$161.57$55.06RVU22D
2022-07-01$161.57$55.06RVU22C
2022-04-01$161.57$55.06RVU22B
2022-01-01$161.57$55.06RVU22A
2021-10-01$164.24$55.99RVU21D
2021-07-01$164.24$55.99RVU21C
2021-04-01$164.24$55.99RVU21B
2021-01-01$164.24$55.99RVU21A
2020-10-01$150.37$56.07RVU20D
2020-07-01$150.37$56.07RVU20C
2020-04-01$150.37$56.07RVU20B
2020-01-01$150.37$56.07RVU20A
2019-10-01$146.34$56.88RVU19D
2019-07-01$146.34$56.88RVU19C
2019-04-01$146.34$56.88RVU19B
2019-01-01$146.34$56.88RVU19A
2018-10-01$150.95$63.76RVU18D
2018-07-01$150.95$63.76RVU18C
2018-04-01$150.95$63.76RVU18B
2018-01-01$150.95$63.76RVU18AR1
2017-10-01$147.59$63.70RVU17D
2017-07-01$147.59$63.70RVU17C
2017-04-01$147.59$63.70RVU17B
2017-01-01$147.59$63.70RVU17A
2016-10-01$146.94$63.24RVU16D
2016-07-01$146.94$63.24RVU16C
2016-04-01$146.94$63.24RVU16B
2016-01-01$146.94$63.24RVU16A
2015-10-01$148.74$63.44RVU15D
2015-07-01$148.74$63.44RVU15C
2015-04-01$148.00$63.13RVU15B
2015-01-01$148.00$63.13RVU15A
2014-10-01$145.50$62.40RVU14D
2014-07-01$145.50$62.40RVU14C
2014-04-01$145.50$62.40RVU14B
2014-01-01$145.50$62.40RVU14A
2013-10-01$150.96$62.10RVU13D
2013-07-01$150.96$62.10RVU13C
2013-04-01$150.96$62.10RVU13B
2013-01-01$150.96$62.10RVU13AR

Price 45300 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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 Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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