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CPT code 45303: Proctosigmoidoscopy, dilation of a narrowing2026 Medicare rate & RVUs in Arkansas

Report rigid proctosigmoidoscopy with dilation when the endoscopist treats a narrowing in the rectum or distal sigmoid under direct visualization.

CMS RVU26DEffective Oct 1, 2026One payment locality536 Medicare services in 2024

In Arkansas, Medicare pays $884.63 for 45303 in the office and $72.67 when it’s performed in a hospital or facility.

$884.63Office (non-facility)
$72.67Hospital or facility
−13.7%vs the national office rate ($1,025.41)

Check a contract rate as a % of Medicare · 45303 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 45303 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Arkansas
  2. What 45303 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 45303 covers

This service combines examination of the rectum and distal sigmoid with dilation of a narrowing seen during rigid proctosigmoidoscopy. A gastroenterologist, colorectal surgeon, or other qualified endoscopist may perform it when a stricture limits passage through the examined segment. The clinician uses a dilation method suited to the narrowing and the patient; the procedure is therapeutic, not simply an inspection of the area.

Report the service when the record supports both rigid proctosigmoidoscopic examination and dilation. Document the narrowing’s location, the treatment performed, and the findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay for an assistant at surgery; co-surgeons and team surgery 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 Arkansas compares for 45303

Across 109 of 109 payment localities, the office rate for 45303 runs from $884.63 in Arkansas to $1,456.49 in San Benito County, CA. Arkansas pays $884.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

45303 in Arkansas vs other payment areas
  1. Arkansas · this page$884.63
  2. Los Angeles, CA · California$1,202.57+$317.94
  3. Washington, DC area · District of Columbia$1,201.76+$317.13
  4. Miami, FL · Florida$1,077.00+$192.37
  5. Chicago, IL · Illinois$1,040.54+$155.91
  6. Manhattan, NY · New York$1,190.30+$305.67
  7. Alaska · Alaska$1,108.02+$223.39

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

Every other payment area

45303 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$900.58$73.49
ArizonaArizona$994.17$78.23
Bakersfield, CACalifornia$1,116.58$80.59
Chico, CACalifornia$1,115.93$79.94
El Centro, CACalifornia$1,115.97$79.98
Fresno, CACalifornia$1,115.93$79.94
Hanford, CACalifornia$1,115.93$79.94
Madera, CACalifornia$1,115.93$79.94

45303 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.

$884.63

$1,286.21

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
45303 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,108.021
AL$900.581
AR$884.631
AZ$994.171
CA$1,115.93–$1,456.4929
CO$1,086.481
CT$1,102.781
DC$1,201.761
DE$1,013.201
FL$986.51–$1,077.003
GA$921.91–$1,042.642
GU$1,155.331
HI$1,155.331
IA$938.161
ID$943.601
IL$945.17–$1,057.904
IN$950.511
KS$928.291
KY$916.871
LA$913.31–$969.112
MA$1,076.09–$1,215.002
MD$1,036.90–$1,201.763
ME$944.75–$1,013.832
MI$941.84–$996.662
MN$1,048.191
MO$891.08–$978.773
MS$888.301
MT$1,025.391
NC$957.511
ND$1,020.841
NE$945.791
NH$1,064.301
NJ$1,117.40–$1,184.332
NM$946.281
NV$1,025.101
NY$974.53–$1,218.625
OH$940.911
OK$919.691
OR$1,019.24–$1,132.062
PA$945.28–$1,067.562
PR$1,035.981
RI$1,057.521
SC$950.391
SD$1,020.311
TN$933.401
TX$937.39–$1,081.008
UT$966.311
VA$1,006.63–$1,201.762
VI$1,035.981
VT$1,011.891
WA$1,075.68–$1,246.932
WI$979.271
WV$901.391
WY$1,023.411

See 45303 in every payment locality

How the 45303 rate is calculated

Each of 45303’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 · 45303

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense29.10

29.10 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

30.7000

Conversion factor

$33.4009

Medicare rate

$1,025.41

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Arkansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,488

Code
45303
Physician work
1.37
Practice expense
29.10
Malpractice
0.23

GPCI2026.csv

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Office calculation for 45303 in Arkansas
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense29.10× 0.85924.9969
Malpractice0.23× 0.5150.1185
Total RVUs26.4854
Conversion factor× 33.4009

Office rate, Arkansas$884.63

Office: (1.37 × 1 + 29.1 × 0.859 + 0.23 × 0.515) × $33.4009 = $884.63

Facility: (1.37 × 1 + 0.8 × 0.859 + 0.23 × 0.515) × $33.4009 = $72.67

Open 45303 in the RVU calculator

Payment rules and modifiers for 45303

The CMS indicators that decide how 45303 is paid alongside other services.

CMS payment indicators · 45303

Proctosigmoidoscopy, dilation of a narrowing

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
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

45303 without 51 · national office

$1,025.41

Proctosigmoidoscopy, dilation of a narrowing

45303-51 · Second procedure: 50%

$512.71

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 45303

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

Codes related to 45303
CodeHow it relatesOffice range, Arkansas
Used instead
45300Proctosigmoidoscopy, rigid, diagnosticRigid proctosigmoidoscopy for diagnostic examination when no dilation is performed.$129.86
45340Sigmoidoscopy dilation, transendoscopic balloonFlexible sigmoidoscopy with dilation, rather than rigid proctosigmoidoscopy.$439.61
Same family
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than dilation.$173.40

How 45303 has changed in Arkansas

45303 · Office / nonfacility

$884.63

Effective 2026-10-01

The base rate is $132.42 higher than on 2025-10-01, moving from $752.21 to $884.63 (17.6%).

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

    $752.21changed to$884.63

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.40 changed to 1.37
    • Practice expense RVU 25.28 changed to 29.10
    • Malpractice RVU 0.22 changed to 0.23
    • Practice expense GPCI 0.860 changed to 0.859
    • Malpractice GPCI 0.518 changed to 0.515

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $807.36changed to$752.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 26.43 changed to 25.28
    • Malpractice RVU 0.24 changed to 0.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $794.18changed to$807.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $841.56changed to$794.18

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 27.34 changed to 26.43
    • Malpractice RVU 0.23 changed to 0.24
    • Practice expense GPCI 0.853 changed to 0.860
    • Malpractice GPCI 0.492 changed to 0.518

  5. January 1, 2023

    RVU23A

    $875.35changed to$841.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 28.09 changed to 27.34
    • Malpractice RVU 0.22 changed to 0.23
    • Practice expense GPCI 0.847 changed to 0.853
    • Malpractice GPCI 0.465 changed to 0.492

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $893.38changed to$875.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 28.46 changed to 28.09
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $849.34changed to$893.38

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 25.64 changed to 28.46
    • Practice expense GPCI 0.859 changed to 0.847
    • Malpractice GPCI 0.521 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $831.77changed to$849.34

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 24.71 changed to 25.64
    • Malpractice RVU 0.23 changed to 0.21
    • Practice expense GPCI 0.872 changed to 0.859
    • Malpractice GPCI 0.576 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $810.66changed to$831.77

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 24.06 changed to 24.71
    • Malpractice RVU 0.24 changed to 0.23

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $803.22changed to$810.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 23.95 changed to 24.06
    • Malpractice RVU 0.26 changed to 0.24
    • Practice expense GPCI 0.870 changed to 0.872
    • Malpractice GPCI 0.555 changed to 0.576

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $850.64changed to$803.22

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.50 changed to 1.40
    • Practice expense RVU 25.50 changed to 23.95
    • Malpractice RVU 0.28 changed to 0.26
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.534 changed to 0.555

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $862.94changed to$850.64

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 25.79 changed to 25.50
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $858.64changed to$862.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $829.67changed to$858.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 24.87 changed to 25.79
    • Malpractice RVU 0.25 changed to 0.29
    • Practice expense GPCI 0.866 changed to 0.867
    • Malpractice GPCI 0.492 changed to 0.534

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $893.18changed to$829.67

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 28.48 changed to 24.87
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 0.865 changed to 0.866
    • Malpractice GPCI 0.450 changed to 0.492

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $893.18

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$884.63$72.67RVU26D
2026-07-01$884.63$72.67RVU26C
2026-04-01$884.63$72.67RVU26B
2026-01-01$884.63$72.67RVU26A
2025-10-01$752.21$75.12RVU25D
2025-07-01$752.21$75.12RVU25C
2025-04-01$752.21$75.12RVU25B
2025-01-01$752.21$75.12RVU25A
2024-10-01$807.36$77.08RVU24D
2024-07-01$807.36$77.08RVU24C
2024-04-01$807.36$77.08RVU24B
2024-03-09$807.36$77.08RVU24AR
2024-01-01$794.18$75.82RVU24A
2023-10-01$841.56$77.29RVU23D
2023-07-01$841.56$77.29RVU23C
2023-04-01$841.56$77.29RVU23B
2023-01-01$841.56$77.29RVU23A
2022-10-01$875.35$77.49RVU22D
2022-07-01$875.35$77.49RVU22C
2022-04-01$875.35$77.49RVU22B
2022-01-01$875.35$77.49RVU22A
2021-10-01$893.38$77.38RVU21D
2021-07-01$893.38$77.38RVU21C
2021-04-01$893.38$77.38RVU21B
2021-01-01$893.38$77.38RVU21A
2020-10-01$849.34$80.51RVU20D
2020-07-01$849.34$80.51RVU20C
2020-04-01$849.34$80.51RVU20B
2020-01-01$849.34$80.51RVU20A
2019-10-01$831.77$81.63RVU19D
2019-07-01$831.77$81.63RVU19C
2019-04-01$831.77$81.63RVU19B
2019-01-01$831.77$81.63RVU19A
2018-10-01$810.66$82.37RVU18D
2018-07-01$810.66$82.37RVU18C
2018-04-01$810.66$82.37RVU18B
2018-01-01$810.66$82.37RVU18AR1
2017-10-01$803.22$82.27RVU17D
2017-07-01$803.22$82.27RVU17C
2017-04-01$803.22$82.27RVU17B
2017-01-01$803.22$82.27RVU17A
2016-10-01$850.64$86.69RVU16D
2016-07-01$850.64$86.69RVU16C
2016-04-01$850.64$86.69RVU16B
2016-01-01$850.64$86.69RVU16A
2015-10-01$862.94$87.50RVU15D
2015-07-01$862.94$87.50RVU15C
2015-04-01$858.64$87.07RVU15B
2015-01-01$858.64$87.07RVU15A
2014-10-01$829.67$86.06RVU14D
2014-07-01$829.67$86.06RVU14C
2014-04-01$829.67$86.06RVU14B
2014-01-01$829.67$86.06RVU14A
2013-10-01$893.18$84.45RVU13D
2013-07-01$893.18$84.45RVU13C
2013-04-01$893.18$84.45RVU13B
2013-01-01$893.18$84.45RVU13AR

Price 45303 for an earlier date of service

Where the Arkansas rate applies

Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.

  • Acorn
  • Adona
  • Alexander
  • Alicia
  • Alix
  • Alleene
  • Allport
  • Alma

Browse all communities in Arkansas

45303 billing questions

How does this differ from 45300?

45300 describes rigid proctosigmoidoscopy for diagnostic examination alone. Report 45303 when the examination includes dilation of a narrowing.

How does this differ from 45340?

45303 is for dilation performed with rigid proctosigmoidoscopy. 45340 describes dilation performed with flexible sigmoidoscopy.

What documentation supports this code?

Document the rigid examination, the narrowing’s location, and the dilation performed. The record should make clear that treatment occurred, not just diagnostic inspection.

Can modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are related endoscopies priced when performed together?

CMS applies endoscopy-family pricing when related endoscopies are performed together. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant-at-surgery claim for this service. Co-surgeon and team-surgery billing are not permitted.

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 45303PPRRVU2026_Oct_nonQPP.csv, line 5,488 (RVU26D)
Geographic factors for ArkansasGPCI2026.csv, line 7 (RVU26D)

Open CMS sourceHow we calculate rates

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