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CPT code 45300: Proctosigmoidoscopy, rigid, diagnostic2026 Medicare rate & RVUs in North Carolina

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 North Carolina, Medicare pays $139.14 for 45300 in the office and $42.54 when it’s performed in a hospital or facility.

$139.14Office (non-facility)
$42.54Hospital or facility
−6.4%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 North Carolina
  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 North Carolina 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. North Carolina pays $139.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

45300 in North Carolina vs other payment areas
  1. North Carolina · this page$139.14
  2. Los Angeles, CA · California$169.88+$30.74
  3. Washington, DC area · District of Columbia$171.58+$32.44
  4. Miami, FL · Florida$160.12+$20.98
  5. Chicago, IL · Illinois$155.03+$15.89
  6. Manhattan, NY · New York$172.00+$32.86
  7. Alaska · Alaska$167.40+$28.26

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

Every other payment area

45300 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$131.97$41.37
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

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 45300 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.78× 1.0000.7800
Practice expense3.54× 0.9333.3028
Malpractice0.13× 0.6390.0831
Total RVUs4.1659
Conversion factor× 33.4009

Office rate, North Carolina$139.14

Office: (0.78 × 1 + 3.54 × 0.933 + 0.13 × 0.639) × $33.4009 = $139.14

Facility: (0.78 × 1 + 0.44 × 0.933 + 0.13 × 0.639) × $33.4009 = $42.54

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, North Carolina
Same family
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than diagnostic examination alone.$185.65
45303Proctosigmoidoscopy, dilation of a narrowingRigid proctosigmoidoscopy with dilation.$957.51
Used instead
45330Flexible sigmoidoscopy, diagnosticDiagnostic examination using a flexible sigmoidoscope instead of a rigid scope.$201.35

How 45300 has changed in North Carolina

45300 · Office / nonfacility

$139.14

Effective 2026-10-01

The base rate is $22.11 higher than on 2025-10-01, moving from $117.03 to $139.14 (18.9%).

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

    $117.03changed to$139.14

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $119.51changed to$117.03

    • 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

    $117.56changed to$119.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $122.80changed to$117.56

    • 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
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $126.50changed to$122.80

    • 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
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $128.45changed to$126.50

    • 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

    $119.48changed to$128.45

    • 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
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $117.31changed to$119.48

    • 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
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $120.87changed to$117.31

    • 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

    $118.33changed to$120.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.58 changed to 2.65
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $117.79changed to$118.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.57 changed to 2.58
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $119.28changed to$117.79

    • 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

    $118.69changed to$119.28

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $117.07changed to$118.69

    • 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
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $121.20changed to$117.07

    • 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
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $121.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$139.14$42.54RVU26D
2026-07-01$139.14$42.54RVU26C
2026-04-01$139.14$42.54RVU26B
2026-01-01$139.14$42.54RVU26A
2025-10-01$117.03$44.55RVU25D
2025-07-01$117.03$44.55RVU25C
2025-04-01$117.03$44.55RVU25B
2025-01-01$117.03$44.55RVU25A
2024-10-01$119.51$45.23RVU24D
2024-07-01$119.51$45.23RVU24C
2024-04-01$119.51$45.23RVU24B
2024-03-09$119.51$45.23RVU24AR
2024-01-01$117.56$44.49RVU24A
2023-10-01$122.80$46.15RVU23D
2023-07-01$122.80$46.15RVU23C
2023-04-01$122.80$46.15RVU23B
2023-01-01$122.80$46.15RVU23A
2022-10-01$126.50$46.54RVU22D
2022-07-01$126.50$46.54RVU22C
2022-04-01$126.50$46.54RVU22B
2022-01-01$126.50$46.54RVU22A
2021-10-01$128.45$47.17RVU21D
2021-07-01$128.45$47.17RVU21C
2021-04-01$128.45$47.17RVU21B
2021-01-01$128.45$47.17RVU21A
2020-10-01$119.48$47.65RVU20D
2020-07-01$119.48$47.65RVU20C
2020-04-01$119.48$47.65RVU20B
2020-01-01$119.48$47.65RVU20A
2019-10-01$117.31$48.19RVU19D
2019-07-01$117.31$48.19RVU19C
2019-04-01$117.31$48.19RVU19B
2019-01-01$117.31$48.19RVU19A
2018-10-01$120.87$53.50RVU18D
2018-07-01$120.87$53.50RVU18C
2018-04-01$120.87$53.50RVU18B
2018-01-01$120.87$53.50RVU18AR1
2017-10-01$118.33$53.51RVU17D
2017-07-01$118.33$53.51RVU17C
2017-04-01$118.33$53.51RVU17B
2017-01-01$118.33$53.51RVU17A
2016-10-01$117.79$53.20RVU16D
2016-07-01$117.79$53.20RVU16C
2016-04-01$117.79$53.20RVU16B
2016-01-01$117.79$53.20RVU16A
2015-10-01$119.28$53.45RVU15D
2015-07-01$119.28$53.45RVU15C
2015-04-01$118.69$53.18RVU15B
2015-01-01$118.69$53.18RVU15A
2014-10-01$117.07$52.84RVU14D
2014-07-01$117.07$52.84RVU14C
2014-04-01$117.07$52.84RVU14B
2014-01-01$117.07$52.84RVU14A
2013-10-01$121.20$52.45RVU13D
2013-07-01$121.20$52.45RVU13C
2013-04-01$121.20$52.45RVU13B
2013-01-01$121.20$52.45RVU13AR

Price 45300 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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