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CPT code 45307: Foreign body removal, rigid proctosigmoidoscopy2026 Medicare rate & RVUs in Puerto Rico

Reports removal of a foreign object from the rectum or distal sigmoid using a rigid proctosigmoidoscope, rather than a flexible sigmoidoscope.

CMS RVU26DEffective Oct 1, 2026One payment locality79 Medicare services in 2024

In Puerto Rico, Medicare pays $238.14 for 45307 in the office and $95.98 when it’s performed in a hospital or facility.

$238.14Office (non-facility)
$95.98Hospital or facility
+0.7%vs the national office rate ($236.48)

Check a contract rate as a % of Medicare · 45307 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 45307 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 45307 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 45307 covers

A clinician advances a rigid proctosigmoidoscope through the anus to locate and retrieve a foreign object in the rectum or distal sigmoid. A gastroenterologist, colorectal surgeon, or other qualified physician may perform the procedure in an office, endoscopy suite, or operating room, depending on the object and clinical circumstances. Retrieval instruments may be passed through the scope. This code describes foreign-body extraction, not removal of a polyp or other lesion.

Report 45307 when the documented procedure uses a rigid proctosigmoidoscope to remove the object. The record should identify the object and its location, the scope used, the retrieval performed, and relevant findings. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Assistant-at-surgery payment requires documentation of medical necessity; 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 Puerto Rico compares for 45307

Across 109 of 109 payment localities, the office rate for 45307 runs from $205.66 in Arkansas to $310.99 in San Benito County, CA. Puerto Rico pays $238.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

45307 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$238.14
  2. Los Angeles, CA · California$265.07+$26.93
  3. Washington, DC area · District of Columbia$271.20+$33.06
  4. Miami, FL · Florida$264.91+$26.77
  5. Chicago, IL · Illinois$255.86+$17.72
  6. Manhattan, NY · New York$275.63+$37.49
  7. Alaska · Alaska$267.30+$29.16

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

Every other payment area

45307 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$209.10$86.06
ArkansasArkansas$205.66$84.87
ArizonaArizona$229.18$92.92
Bakersfield, CACalifornia$248.34$94.22
Chico, CACalifornia$247.21$93.09
El Centro, CACalifornia$247.28$93.16
Fresno, CACalifornia$247.21$93.09
Hanford, CACalifornia$247.21$93.09

45307 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.

$205.66

$279.10

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

View every state and territory as a table
45307 office rate range by state
State / territoryOffice rate rangeLocalities
AK$267.301
AL$209.101
AR$205.661
AZ$229.181
CA$247.21–$310.9929
CO$244.931
CT$253.581
DC$271.201
DE$233.281
FL$236.04–$264.913
GA$220.77–$242.182
GU$253.911
HI$253.911
IA$213.541
ID$215.461
IL$229.56–$255.864
IN$216.831
KS$213.171
KY$216.381
LA$216.30–$228.342
MA$243.49–$270.122
MD$237.89–$271.203
ME$217.55–$229.772
MI$223.47–$240.142
MN$231.541
MO$212.61–$228.333
MS$209.141
MT$236.451
NC$220.001
ND$228.151
NE$214.641
NH$241.711
NJ$255.60–$267.972
NM$225.161
NV$234.311
NY$223.79–$284.035
OH$221.771
OK$215.121
OR$231.63–$252.632
PA$221.74–$247.112
PR$238.141
RI$241.571
SC$221.431
SD$227.161
TN$214.481
TX$220.15–$244.868
UT$224.831
VA$229.46–$271.202
VI$238.141
VT$227.841
WA$242.83–$275.182
WI$219.621
WV$220.211
WY$232.831

See 45307 in every payment locality

How the 45307 rate is calculated

Each of 45307’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 · 45307

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.56

1.56 RVUs× 1.000 GPCI

Practice expense5.10

5.10 RVUs× 1.000 GPCI

Malpractice0.42

0.42 RVUs× 1.000 GPCI

Adjusted RVUs

7.0800

Conversion factor

$33.4009

Medicare rate

$236.48

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,490

Code
45307
Physician work
1.56
Practice expense
5.10
Malpractice
0.42

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 45307 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.56× 1.0001.5600
Practice expense5.10× 1.0115.1561
Malpractice0.42× 0.9850.4137
Total RVUs7.1298
Conversion factor× 33.4009

Office rate, Puerto Rico$238.14

Office: (1.56 × 1 + 5.1 × 1.011 + 0.42 × 0.985) × $33.4009 = $238.14

Facility: (1.56 × 1 + 0.89 × 1.011 + 0.42 × 0.985) × $33.4009 = $95.98

Open 45307 in the RVU calculator

Payment rules and modifiers for 45307

The CMS indicators that decide how 45307 is paid alongside other services.

CMS payment indicators · 45307

Foreign body removal, rigid proctosigmoidoscopy

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)0Not paid without supporting documentation.
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

45307 without 51 · national office

$236.48

Foreign body removal, rigid proctosigmoidoscopy

45307-51 · Second procedure: 50%

$118.24

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 45307

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

Codes related to 45307
CodeHow it relatesOffice range, Puerto Rico
Same family
45300Proctosigmoidoscopy, rigid, diagnosticRigid proctosigmoidoscopy for diagnostic examination, without the foreign-body removal service.$149.87
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than foreign-body retrieval.$200.00
45308Lesion removal, rigid scope, cautery techniqueRigid proctosigmoidoscopy for lesion removal, not retrieval of a foreign object.$228.85
Used instead
45332Flexible sigmoidoscopy, foreign body removalForeign-body removal performed with flexible sigmoidoscopy instead of a rigid proctosigmoidoscope.$315.59

How 45307 has changed in Puerto Rico

45307 · Office / nonfacility

$238.14

Effective 2026-10-01

The base rate is $32.64 higher than on 2025-10-01, moving from $205.50 to $238.14 (15.9%).

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

    $205.50changed to$238.14

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.60 changed to 1.56
    • Practice expense RVU 4.33 changed to 5.10
    • Malpractice RVU 0.40 changed to 0.42
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $214.16changed to$205.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.41 changed to 4.33

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $210.67changed to$214.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $220.59changed to$210.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.48 changed to 4.41
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $219.59changed to$220.59

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $228.78changed to$219.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.58 changed to 4.48
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $212.89changed to$228.78

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.26 changed to 4.58
    • Malpractice RVU 0.21 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $193.25changed to$212.89

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.47 changed to 4.26
    • Malpractice RVU 0.26 changed to 0.21
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $181.98changed to$193.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.17 changed to 3.47
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $171.63changed to$181.98

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.88 changed to 3.17
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $151.66changed to$171.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.85 changed to 2.88
    • Malpractice RVU 0.29 changed to 0.27
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $180.02changed to$151.66

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.70 changed to 1.60
    • Practice expense RVU 4.55 changed to 2.85
    • Malpractice RVU 0.41 changed to 0.29
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $175.61changed to$180.02

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.40 changed to 4.55
    • Malpractice RVU 0.29 changed to 0.41

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $174.73changed to$175.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $176.05changed to$174.73

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.52 changed to 4.40
    • Malpractice RVU 0.32 changed to 0.29
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $179.20changed to$176.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.14 changed to 4.52
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $179.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$238.14$95.98RVU26D
2026-07-01$238.14$95.98RVU26C
2026-04-01$238.14$95.98RVU26B
2026-01-01$238.14$95.98RVU26A
2025-10-01$205.50$98.34RVU25D
2025-07-01$205.50$98.34RVU25C
2025-04-01$205.50$98.34RVU25B
2025-01-01$205.50$98.34RVU25A
2024-10-01$214.16$100.19RVU24D
2024-07-01$214.16$100.19RVU24C
2024-04-01$214.16$100.19RVU24B
2024-03-09$214.16$100.19RVU24AR
2024-01-01$210.67$98.56RVU24A
2023-10-01$220.59$101.03RVU23D
2023-07-01$219.59$100.98RVU23C
2023-04-01$219.59$100.98RVU23B
2023-01-01$219.59$100.98RVU23A
2022-10-01$228.78$103.20RVU22D
2022-07-01$228.78$103.20RVU22C
2022-04-01$228.78$103.20RVU22B
2022-01-01$228.78$103.20RVU22A
2021-10-01$212.89$97.52RVU21D
2021-07-01$212.89$97.52RVU21C
2021-04-01$212.89$97.52RVU21B
2021-01-01$212.89$97.52RVU21A
2020-10-01$193.25$101.57RVU20D
2020-07-01$193.25$101.57RVU20C
2020-04-01$193.25$101.57RVU20B
2020-01-01$193.25$101.57RVU20A
2019-10-01$181.98$100.69RVU19D
2019-07-01$181.98$100.69RVU19C
2019-04-01$181.98$100.69RVU19B
2019-01-01$181.98$100.69RVU19A
2018-10-01$171.63$100.94RVU18D
2018-07-01$171.63$100.94RVU18C
2018-04-01$171.63$100.94RVU18B
2018-01-01$171.63$100.94RVU18AR1
2017-10-01$151.66$92.98RVU17D
2017-07-01$151.66$92.98RVU17C
2017-04-01$151.66$92.98RVU17B
2017-01-01$151.66$92.98RVU17A
2016-10-01$180.02$89.65RVU16D
2016-07-01$180.02$89.65RVU16C
2016-04-01$180.02$89.65RVU16B
2016-01-01$180.02$89.65RVU16A
2015-10-01$175.61$88.97RVU15D
2015-07-01$175.61$88.97RVU15C
2015-04-01$174.73$88.52RVU15B
2015-01-01$174.73$88.52RVU15A
2014-10-01$176.05$88.05RVU14D
2014-07-01$176.05$88.05RVU14C
2014-04-01$176.05$88.05RVU14B
2014-01-01$176.05$88.05RVU14A
2013-10-01$179.20$85.55RVU13D
2013-07-01$179.20$85.55RVU13C
2013-04-01$179.20$85.55RVU13B
2013-01-01$179.20$85.55RVU13AR

Price 45307 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

45307 billing questions

When should 45307 be chosen instead of 45332?

Use 45307 when the foreign body is removed with a rigid proctosigmoidoscope. Code 45332 describes foreign-body removal during flexible sigmoidoscopy.

Is 45307 appropriate for removing a polyp?

No. This code is for retrieval of a foreign object. Choose the code that describes the documented lesion-removal method when a polyp or other lesion is removed.

What should the procedure note support?

Document the foreign object, its location, use of a rigid proctosigmoidoscope, and the retrieval performed. Include relevant findings from the examination.

How are related endoscopies priced when performed together?

CMS endoscopy family pricing applies when related endoscopies are performed together.

Does the 0-day global include same-day care?

Yes. Same-day preoperative and postoperative care is included in the 0-day global period.

When can an assistant-at-surgery be paid?

Assistant-at-surgery payment is available only when the documentation supports medical necessity.

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 45307PPRRVU2026_Oct_nonQPP.csv, line 5,490 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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