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

In Vermont, Medicare pays $193.56 for 45305 in the office and $65.59 when it’s performed in a hospital or facility.

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.

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 Vermont 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. Vermont pays $193.56. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

45305 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

Payment rules and modifiers for 45305

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

What modifiers do to the payment

When to use modifier 51

Codes related to 45305

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

How 45305 has changed in Vermont

Price 45305 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates