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CPT code 45305: Proctosigmoidoscopy, rigid scope with biopsy2026 Medicare rate & RVUs in Connecticut

Reports rigid examination of the rectum and distal sigmoid with tissue sampling to evaluate abnormal mucosa, a lesion, or another finding.

CMS RVU26DEffective Oct 1, 2026One payment locality351 Medicare services in 2024

In Connecticut, Medicare pays $212.43 for 45305 in the office and $73.22 when it’s performed in a hospital or facility.

$212.43Office (non-facility)
$73.22Hospital or facility
+7.1%vs the national office rate ($198.40)

Check a contract rate as a % of Medicare · 45305 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 45305 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 45305 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 45305 covers

The clinician advances a rigid proctosigmoidoscope to inspect the rectum and distal sigmoid and takes one or more tissue samples during the examination. Common reasons include sampling abnormal mucosa, an ulcer, or a suspicious lesion. Gastroenterologists and colorectal surgeons may perform the procedure in an office or a facility-based endoscopy setting. The biopsy is part of this service; the code covers obtaining the sample, not the laboratory examination of the tissue.

Choose this code when the documented procedure uses a rigid scope and includes biopsy. A diagnostic rigid examination without biopsy is coded differently; a flexible sigmoidoscopy with biopsy is a different service. Record the scope type, examination performed, and biopsy site or sites. 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. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing 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 Connecticut compares for 45305

Across 109 of 109 payment localities, the office rate for 45305 runs from $173.40 in Arkansas to $267.62 in San Benito County, CA. Connecticut pays $212.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

45305 in Connecticut vs other payment areas
  1. Connecticut · this page$212.43
  2. Los Angeles, CA · California$225.93+$13.50
  3. Washington, DC area · District of Columbia$228.64+$16.21
  4. Miami, FL · Florida$214.94+$2.51
  5. Chicago, IL · Illinois$208.09−$4.34
  6. Manhattan, NY · New York$229.71+$17.28
  7. Alaska · Alaska$224.14+$11.71

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

Every other payment area

45305 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$176.21$63.11
ArkansasArkansas$173.40$62.37
ArizonaArizona$192.66$67.40
Bakersfield, CACalifornia$211.31$69.64
Chico, CACalifornia$210.75$69.08
El Centro, CACalifornia$210.79$69.11
Fresno, CACalifornia$210.75$69.08
Hanford, CACalifornia$210.75$69.08

45305 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.

$173.40

$239.19

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

View every state and territory as a table
45305 office rate range by state
State / territoryOffice rate rangeLocalities
AK$224.141
AL$176.211
AR$173.401
AZ$192.661
CA$210.75–$267.6229
CO$207.261
CT$212.431
DC$228.641
DE$196.061
FL$194.97–$214.943
GA$183.02–$202.332
GU$216.731
HI$216.731
IA$181.261
ID$182.541
IL$188.74–$208.094
IN$183.701
KS$180.271
KY$180.701
LA$180.37–$190.212
MA$205.82–$229.142
MD$200.08–$228.643
ME$183.53–$194.552
MI$185.84–$197.582
MN$198.171
MO$176.93–$191.013
MS$175.211
MT$198.391
NC$185.651
ND$194.431
NE$182.361
NH$203.891
NJ$214.74–$225.902
NM$186.941
NV$197.441
NY$188.70–$235.695
OH$185.031
OK$180.401
OR$195.80–$214.422
PA$185.38–$206.692
PR$200.001
RI$203.481
SC$185.671
SD$193.971
TN$181.271
TX$184.04–$206.668
UT$188.461
VA$193.81–$228.642
VI$200.001
VT$193.561
WA$205.47–$234.082
WI$187.301
WV$181.071
WY$196.661

See 45305 in every payment locality

How the 45305 rate is calculated

Each of 45305’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 · 45305

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.12

1.12 RVUs× 1.000 GPCI

Practice expense4.62

4.62 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

5.9400

Conversion factor

$33.4009

Medicare rate

$198.40

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,489

Code
45305
Physician work
1.12
Practice expense
4.62
Malpractice
0.20

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 45305 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.12× 1.0201.1424
Practice expense4.62× 1.0774.9757
Malpractice0.20× 1.2100.2420
Total RVUs6.3601
Conversion factor× 33.4009

Office rate, Connecticut$212.43

Office: (1.12 × 1.02 + 4.62 × 1.077 + 0.2 × 1.21) × $33.4009 = $212.43

Facility: (1.12 × 1.02 + 0.75 × 1.077 + 0.2 × 1.21) × $33.4009 = $73.22

Open 45305 in the RVU calculator

Payment rules and modifiers for 45305

The CMS indicators that decide how 45305 is paid alongside other services.

CMS payment indicators · 45305

Proctosigmoidoscopy, rigid scope with biopsy

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

45305 without 51 · national office

$198.40

Proctosigmoidoscopy, rigid scope with biopsy

45305-51 · Second procedure: 50%

$99.20

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 45305

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

Codes related to 45305
CodeHow it relatesOffice range, Connecticut
Same family
45300Proctosigmoidoscopy, rigid, diagnosticRigid diagnostic proctosigmoidoscopy without biopsy.$159.17
45303Proctosigmoidoscopy, dilation of a narrowingRigid proctosigmoidoscopy with dilation rather than tissue sampling.$1,102.78
45308Lesion removal, rigid scope, cautery techniqueRigid proctosigmoidoscopy with lesion removal rather than biopsy alone.$243.75
Used instead
45331Sigmoidoscopy, with biopsyFlexible sigmoidoscopy with biopsy when a flexible scope is used.$346.37

How 45305 has changed in Connecticut

45305 · Office / nonfacility

$212.43

Effective 2026-10-01

The base rate is $26.15 higher than on 2025-10-01, moving from $186.28 to $212.43 (14.0%).

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

    $186.28changed to$212.43

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.15 changed to 1.12
    • Practice expense RVU 3.98 changed to 4.62
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $195.69changed to$186.28

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.09 changed to 3.98

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $192.50changed to$195.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $201.63changed to$192.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.14 changed to 4.09
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $208.88changed to$201.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.18 changed to 4.14
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $205.95changed to$208.88

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.06 changed to 4.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $182.36changed to$205.95

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.29 changed to 4.06
    • Malpractice RVU 0.19 changed to 0.20
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $172.84changed to$182.36

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.02 changed to 3.29
    • Malpractice RVU 0.21 changed to 0.19
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $161.84changed to$172.84

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.75 changed to 3.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $159.83changed to$161.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.70 changed to 2.75
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $219.73changed to$159.83

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.25 changed to 1.15
    • Practice expense RVU 4.08 changed to 2.70
    • Malpractice RVU 0.23 changed to 0.21
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $221.29changed to$219.73

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.11 changed to 4.08
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $220.19changed to$221.29

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $219.09changed to$220.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.09 changed to 4.11
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $228.07changed to$219.09

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.63 changed to 4.09
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $228.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$212.43$73.22RVU26D
2026-07-01$212.43$73.22RVU26C
2026-04-01$212.43$73.22RVU26B
2026-01-01$212.43$73.22RVU26A
2025-10-01$186.28$75.82RVU25D
2025-07-01$186.28$75.82RVU25C
2025-04-01$186.28$75.82RVU25B
2025-01-01$186.28$75.82RVU25A
2024-10-01$195.69$77.30RVU24D
2024-07-01$195.69$77.30RVU24C
2024-04-01$195.69$77.30RVU24B
2024-03-09$195.69$77.30RVU24AR
2024-01-01$192.50$76.04RVU24A
2023-10-01$201.63$77.65RVU23D
2023-07-01$201.63$77.65RVU23C
2023-04-01$201.63$77.65RVU23B
2023-01-01$201.63$77.65RVU23A
2022-10-01$208.88$78.19RVU22D
2022-07-01$208.88$78.19RVU22C
2022-04-01$208.88$78.19RVU22B
2022-01-01$208.88$78.19RVU22A
2021-10-01$205.95$78.45RVU21D
2021-07-01$205.95$78.45RVU21C
2021-04-01$205.95$78.45RVU21B
2021-01-01$205.95$78.45RVU21A
2020-10-01$182.36$80.74RVU20D
2020-07-01$182.36$80.74RVU20C
2020-04-01$182.36$80.74RVU20B
2020-01-01$182.36$80.74RVU20A
2019-10-01$172.84$81.87RVU19D
2019-07-01$172.84$81.87RVU19C
2019-04-01$172.84$81.87RVU19B
2019-01-01$172.84$81.87RVU19A
2018-10-01$161.84$82.58RVU18D
2018-07-01$161.84$82.58RVU18C
2018-04-01$161.84$82.58RVU18B
2018-01-01$161.84$82.58RVU18AR1
2017-10-01$159.83$82.46RVU17D
2017-07-01$159.83$82.46RVU17C
2017-04-01$159.83$82.46RVU17B
2017-01-01$159.83$82.46RVU17A
2016-10-01$219.73$88.08RVU16D
2016-07-01$219.73$88.08RVU16C
2016-04-01$219.73$88.08RVU16B
2016-01-01$219.73$88.08RVU16A
2015-10-01$221.29$88.77RVU15D
2015-07-01$221.29$88.77RVU15C
2015-04-01$220.19$88.32RVU15B
2015-01-01$220.19$88.32RVU15A
2014-10-01$219.09$87.96RVU14D
2014-07-01$219.09$87.96RVU14C
2014-04-01$219.09$87.96RVU14B
2014-01-01$219.09$87.96RVU14A
2013-10-01$228.07$87.58RVU13D
2013-07-01$228.07$87.58RVU13C
2013-04-01$228.07$87.58RVU13B
2013-01-01$228.07$87.58RVU13AR

Price 45305 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

45305 billing questions

How does this differ from 45300?

Use 45305 when the rigid proctosigmoidoscopy includes tissue sampling. Code 45300 describes the diagnostic rigid examination without biopsy.

Can I report this for a flexible sigmoidoscopy biopsy?

No. This code is for a rigid proctosigmoidoscopy with biopsy; 45331 is the corresponding flexible sigmoidoscopy biopsy service.

Is biopsy included in the procedure?

Yes. Obtaining the biopsy specimen is included in 45305. The tissue laboratory examination is a separate service when performed and reported by the appropriate laboratory provider.

Should modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this service, so do not use modifier 50.

What happens when another related endoscopy is performed in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together. Document each service performed and do not assume each procedure receives independent full payment.

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 45305PPRRVU2026_Oct_nonQPP.csv, line 5,489 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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