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

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 Rhode Island, Medicare pays $1,057.52 for 45303 in the office and $81.08 when it’s performed in a hospital or facility.

$1,057.52Office (non-facility)
$81.08Hospital or facility
+3.1%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 Rhode Island
  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 Rhode Island 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. Rhode Island pays $1,057.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

45303 in Rhode Island vs other payment areas
  1. Rhode Island · this page$1,057.52
  2. Los Angeles, CA · California$1,202.57+$145.05
  3. Washington, DC area · District of Columbia$1,201.76+$144.24
  4. Miami, FL · Florida$1,077.00+$19.48
  5. Chicago, IL · Illinois$1,040.54−$16.98
  6. Manhattan, NY · New York$1,190.30+$132.78
  7. Alaska · Alaska$1,108.02+$50.50

Other areas in Rhode Island 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
ArkansasArkansas$884.63$72.67
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

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 Rhode Island 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

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 45303 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0191.3960
Practice expense29.10× 1.03330.0603
Malpractice0.23× 0.8920.2052
Total RVUs31.6615
Conversion factor× 33.4009

Office rate, Rhode Island$1057.52

Office: (1.37 × 1.019 + 29.1 × 1.033 + 0.23 × 0.892) × $33.4009 = $1057.52

Facility: (1.37 × 1.019 + 0.8 × 1.033 + 0.23 × 0.892) × $33.4009 = $81.08

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, Rhode Island
Used instead
45300Proctosigmoidoscopy, rigid, diagnosticRigid proctosigmoidoscopy for diagnostic examination when no dilation is performed.$152.56
45340Sigmoidoscopy dilation, transendoscopic balloonFlexible sigmoidoscopy with dilation, rather than rigid proctosigmoidoscopy.$522.73
Same family
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than dilation.$203.48

How 45303 has changed in Rhode Island

45303 · Office / nonfacility

$1057.52

Effective 2026-10-01

The base rate is $155.45 higher than on 2025-10-01, moving from $902.07 to $1057.52 (17.2%).

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

    $902.07changed to$1057.52

    • 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
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $968.65changed to$902.07

    • 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

    $952.84changed to$968.65

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1022.91changed to$952.84

    • 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
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849

  5. January 1, 2023

    RVU23A

    $1075.68changed to$1022.91

    • 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
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1097.79changed to$1075.68

    • 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

    $1029.92changed to$1097.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 25.64 changed to 28.46
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $995.15changed to$1029.92

    • 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
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $969.85changed to$995.15

    • 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

    $963.93changed to$969.85

    • 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
    • Work GPCI 1.025 changed to 1.027
    • Practice expense GPCI 1.052 changed to 1.050
    • Malpractice GPCI 0.879 changed to 0.999

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1023.90changed to$963.93

    • 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
    • Work GPCI 1.022 changed to 1.025
    • Practice expense GPCI 1.053 changed to 1.052
    • Malpractice GPCI 0.759 changed to 0.879

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1038.84changed to$1023.90

    • 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

    $1033.67changed to$1038.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1001.65changed to$1033.67

    • 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
    • Work GPCI 1.020 changed to 1.022
    • Malpractice GPCI 0.973 changed to 0.759

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$1001.65

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,057.52$81.08RVU26D
2026-07-01$1,057.52$81.08RVU26C
2026-04-01$1,057.52$81.08RVU26B
2026-01-01$1,057.52$81.08RVU26A
2025-10-01$902.07$84.05RVU25D
2025-07-01$902.07$84.05RVU25C
2025-04-01$902.07$84.05RVU25B
2025-01-01$902.07$84.05RVU25A
2024-10-01$968.65$86.37RVU24D
2024-07-01$968.65$86.37RVU24C
2024-04-01$968.65$86.37RVU24B
2024-03-09$968.65$86.37RVU24AR
2024-01-01$952.84$84.96RVU24A
2023-10-01$1,022.91$87.51RVU23D
2023-07-01$1,022.91$87.51RVU23C
2023-04-01$1,022.91$87.51RVU23B
2023-01-01$1,022.91$87.51RVU23A
2022-10-01$1,075.68$88.49RVU22D
2022-07-01$1,075.68$88.49RVU22C
2022-04-01$1,075.68$88.49RVU22B
2022-01-01$1,075.68$88.49RVU22A
2021-10-01$1,097.79$88.15RVU21D
2021-07-01$1,097.79$88.15RVU21C
2021-04-01$1,097.79$88.15RVU21B
2021-01-01$1,097.79$88.15RVU21A
2020-10-01$1,029.92$91.04RVU20D
2020-07-01$1,029.92$91.04RVU20C
2020-04-01$1,029.92$91.04RVU20B
2020-01-01$1,029.92$91.04RVU20A
2019-10-01$995.15$91.88RVU19D
2019-07-01$995.15$91.88RVU19C
2019-04-01$995.15$91.88RVU19B
2019-01-01$995.15$91.88RVU19A
2018-10-01$969.85$92.90RVU18D
2018-07-01$969.85$92.90RVU18C
2018-04-01$969.85$92.90RVU18B
2018-01-01$969.85$92.90RVU18AR1
2017-10-01$963.93$92.17RVU17D
2017-07-01$963.93$92.17RVU17C
2017-04-01$963.93$92.17RVU17B
2017-01-01$963.93$92.17RVU17A
2016-10-01$1,023.90$96.05RVU16D
2016-07-01$1,023.90$96.05RVU16C
2016-04-01$1,023.90$96.05RVU16B
2016-01-01$1,023.90$96.05RVU16A
2015-10-01$1,038.84$97.05RVU15D
2015-07-01$1,038.84$97.05RVU15C
2015-04-01$1,033.67$96.57RVU15B
2015-01-01$1,033.67$96.57RVU15A
2014-10-01$1,001.65$97.47RVU14D
2014-07-01$1,001.65$97.47RVU14C
2014-04-01$1,001.65$97.47RVU14B
2014-01-01$1,001.65$97.47RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 45303 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

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 Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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