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

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 Miami, FL, Medicare pays $214.94 for 45305 in the office and $80.38 when it’s performed in a hospital or facility.

$214.94Office (non-facility)
$80.38Hospital or facility
+8.3%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 Miami, FL
  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 Miami, FL 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. Miami, FL pays $214.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

45305 in Miami, FL vs other payment areas
  1. Miami, FL · this page$214.94
  2. Fort Lauderdale, FL · Florida$205.80−$9.14
  3. Rest of Florida · Florida$194.97−$19.97
  4. Los Angeles, CA · California$225.93+$10.99
  5. Washington, DC area · District of Columbia$228.64+$13.70
  6. Chicago, IL · Illinois$208.09−$6.85
  7. Manhattan, NY · New York$229.71+$14.77

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

Every other payment area

45305 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$224.14$86.47
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

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 Miami, FL 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

42

Locality
Miami, FL
Physician work
1.000
Practice expense
1.041
Malpractice
2.529
Office calculation for 45305 in Miami, FL
ComponentRVULocality factorAdjusted
Physician work1.12× 1.0001.1200
Practice expense4.62× 1.0414.8094
Malpractice0.20× 2.5290.5058
Total RVUs6.4352
Conversion factor× 33.4009

Office rate, Miami, FL$214.94

Office: (1.12 × 1 + 4.62 × 1.041 + 0.2 × 2.529) × $33.4009 = $214.94

Facility: (1.12 × 1 + 0.75 × 1.041 + 0.2 × 2.529) × $33.4009 = $80.38

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, Miami, FL
Same family
45300Proctosigmoidoscopy, rigid, diagnosticRigid diagnostic proctosigmoidoscopy without biopsy.$160.12
45303Proctosigmoidoscopy, dilation of a narrowingRigid proctosigmoidoscopy with dilation rather than tissue sampling.$1,077.00
45308Lesion removal, rigid scope, cautery techniqueRigid proctosigmoidoscopy with lesion removal rather than biopsy alone.$252.09
Used instead
45331Sigmoidoscopy, with biopsyFlexible sigmoidoscopy with biopsy when a flexible scope is used.$341.67

How 45305 has changed in Miami, FL

45305 · Office / nonfacility

$214.94

Effective 2026-10-01

The base rate is $29.35 higher than on 2025-10-01, moving from $185.59 to $214.94 (15.8%).

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

    $185.59changed to$214.94

    • 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
    • Practice expense GPCI 1.027 changed to 1.041
    • Malpractice GPCI 2.500 changed to 2.529

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $194.75changed to$185.59

    • 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

    $191.57changed to$194.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $199.28changed to$191.57

    • 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
    • Practice expense GPCI 1.025 changed to 1.027
    • Malpractice GPCI 2.564 changed to 2.500

  5. January 1, 2023

    RVU23A

    $205.97changed to$199.28

    • 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
    • Practice expense GPCI 1.023 changed to 1.025
    • Malpractice GPCI 2.629 changed to 2.564

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $203.40changed to$205.97

    • 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

    $181.14changed to$203.40

    • 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
    • Practice expense GPCI 1.026 changed to 1.023
    • Malpractice GPCI 2.598 changed to 2.629

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $172.86changed to$181.14

    • 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
    • Practice expense GPCI 1.029 changed to 1.026
    • Malpractice GPCI 2.566 changed to 2.598

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $162.67changed to$172.86

    • 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

    $160.23changed to$162.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.70 changed to 2.75
    • Practice expense GPCI 1.031 changed to 1.029
    • Malpractice GPCI 2.528 changed to 2.566

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $216.16changed to$160.23

    • 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
    • Practice expense GPCI 1.033 changed to 1.031
    • Malpractice GPCI 2.490 changed to 2.528

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $217.16changed to$216.16

    • 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

    $216.08changed to$217.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $218.65changed to$216.08

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.09 changed to 4.11
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 2.653 changed to 2.490

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $230.59changed to$218.65

    • 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 1.054 changed to 1.044
    • Malpractice GPCI 2.815 changed to 2.653

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $230.59

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$214.94$80.38RVU26D
2026-07-01$214.94$80.38RVU26C
2026-04-01$214.94$80.38RVU26B
2026-01-01$214.94$80.38RVU26A
2025-10-01$185.59$81.61RVU25D
2025-07-01$185.59$81.61RVU25C
2025-04-01$185.59$81.61RVU25B
2025-01-01$185.59$81.61RVU25A
2024-10-01$194.75$83.30RVU24D
2024-07-01$194.75$83.30RVU24C
2024-04-01$194.75$83.30RVU24B
2024-03-09$194.75$83.30RVU24AR
2024-01-01$191.57$81.94RVU24A
2023-10-01$199.28$83.96RVU23D
2023-07-01$199.28$83.96RVU23C
2023-04-01$199.28$83.96RVU23B
2023-01-01$199.28$83.96RVU23A
2022-10-01$205.97$85.96RVU22D
2022-07-01$205.97$85.96RVU22C
2022-04-01$205.97$85.96RVU22B
2022-01-01$205.97$85.96RVU22A
2021-10-01$203.40$86.32RVU21D
2021-07-01$203.40$86.32RVU21C
2021-04-01$203.40$86.32RVU21B
2021-01-01$203.40$86.32RVU21A
2020-10-01$181.14$87.46RVU20D
2020-07-01$181.14$87.46RVU20C
2020-04-01$181.14$87.46RVU20B
2020-01-01$181.14$87.46RVU20A
2019-10-01$172.86$88.68RVU19D
2019-07-01$172.86$88.68RVU19C
2019-04-01$172.86$88.68RVU19B
2019-01-01$172.86$88.68RVU19A
2018-10-01$162.67$89.32RVU18D
2018-07-01$162.67$89.32RVU18C
2018-04-01$162.67$89.32RVU18B
2018-01-01$162.67$89.32RVU18AR1
2017-10-01$160.23$88.82RVU17D
2017-07-01$160.23$88.82RVU17C
2017-04-01$160.23$88.82RVU17B
2017-01-01$160.23$88.82RVU17A
2016-10-01$216.16$94.85RVU16D
2016-07-01$216.16$94.85RVU16C
2016-04-01$216.16$94.85RVU16B
2016-01-01$216.16$94.85RVU16A
2015-10-01$217.16$95.04RVU15D
2015-07-01$217.16$95.04RVU15C
2015-04-01$216.08$94.57RVU15B
2015-01-01$216.08$94.57RVU15A
2014-10-01$218.65$95.98RVU14D
2014-07-01$218.65$95.98RVU14C
2014-04-01$218.65$95.98RVU14B
2014-01-01$218.65$95.98RVU14A
2013-10-01$230.59$97.19RVU13D
2013-07-01$230.59$97.19RVU13C
2013-04-01$230.59$97.19RVU13B
2013-01-01$230.59$97.19RVU13AR

Price 45305 for an earlier date of service

Where the Miami, FL rate applies

Miami, FL is a Medicare payment area, not a city. Our Census mapping connects it to 83 cities and communities in Florida. Some span more than one payment area; confirm with the service ZIP.

  • Miami
  • Aventura
  • Bal Harbour
  • Bay Harbor Islands
  • Big Coppitt Key
  • Big Pine Key
  • Biscayne Gardens
  • Biscayne Park

Browse all communities in Florida

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 Miami, FLGPCI2026.csv, line 42 (RVU26D)

Open CMS sourceHow we calculate rates

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