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CPT code 45315: Proctosigmoidoscopy, snare removal of lesion2026 Medicare rate & RVUs in Washington, DC area

Report this service when a clinician uses a rigid proctosigmoidoscope to remove a rectal or distal sigmoid polyp or other lesion with a snare.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $288.08 for 45315 in the office and $110.23 when it’s performed in a hospital or facility.

$288.08Office (non-facility)
$110.23Hospital or facility
+14.7%vs the national office rate ($251.17)

Check a contract rate as a % of Medicare · 45315 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 45315 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 45315 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 45315 covers

This procedure combines examination through a rigid proctosigmoidoscope with snare removal of a lesion in the rectum or distal sigmoid colon. A colorectal surgeon or gastroenterologist may perform it when a polyp can be reached through the rigid instrument. The procedure may take place in an office or outpatient facility, depending on the patient and setting.

Select this code from the operative note’s scope type, lesion location, and removal technique; a flexible sigmoidoscope or biopsy alone points to a different code. The diagnostic examination inherent in the removal is included. When related endoscopies are performed together, CMS applies endoscopy family pricing rather than simply adding their full payments. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this anatomy. CMS does not pay an assistant at surgery for this code and does not permit co-surgeons or team surgery.

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 Washington, DC area compares for 45315

Across 109 of 109 payment localities, the office rate for 45315 runs from $218.64 in Arkansas to $330.77 in San Benito County, CA. Washington, DC area pays $288.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

45315 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$288.08
  2. Los Angeles, CA · California$281.81−$6.27
  3. Miami, FL · Florida$280.57−$7.51
  4. Chicago, IL · Illinois$271.07−$17.01
  5. Manhattan, NY · New York$292.52+$4.44
  6. Alaska · Alaska$284.24−$3.84
  7. Alabama · Alabama$222.27−$65.81

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

45315 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$218.64$88.95
ArizonaArizona$243.48$97.19
Bakersfield, CACalifornia$264.02$98.56
Chico, CACalifornia$262.86$97.40
El Centro, CACalifornia$262.94$97.47
Fresno, CACalifornia$262.86$97.40
Hanford, CACalifornia$262.86$97.40
Madera, CACalifornia$262.86$97.40

45315 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.

$218.64

$296.82

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

View every state and territory as a table
45315 office rate range by state
State / territoryOffice rate rangeLocalities
AK$284.241
AL$222.271
AR$218.641
AZ$243.481
CA$262.86–$330.7729
CO$260.301
CT$269.271
DC$288.081
DE$247.821
FL$250.42–$280.573
GA$234.34–$257.132
GU$269.981
HI$269.981
IA$227.101
ID$229.101
IL$243.48–$271.074
IN$230.551
KS$226.641
KY$229.821
LA$229.71–$242.432
MA$258.76–$287.052
MD$252.73–$288.083
ME$231.24–$244.242
MI$237.25–$254.682
MN$246.321
MO$225.77–$242.503
MS$222.221
MT$251.151
NC$233.841
ND$242.641
NE$228.281
NH$256.821
NJ$271.47–$284.662
NM$239.011
NV$248.961
NY$237.84–$301.315
OH$235.511
OK$228.571
OR$246.18–$268.522
PA$235.51–$262.382
PR$252.951
RI$256.661
SC$235.241
SD$241.641
TN$228.021
TX$233.83–$260.178
UT$238.831
VA$243.87–$288.082
VI$252.951
VT$242.271
WA$258.08–$292.492
WI$233.621
WV$233.611
WY$247.441

See 45315 in every payment locality

How the 45315 rate is calculated

Each of 45315’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 · 45315

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.66

1.66 RVUs× 1.000 GPCI

Practice expense5.43

5.43 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

7.5200

Conversion factor

$33.4009

Medicare rate

$251.17

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,493

Code
45315
Physician work
1.66
Practice expense
5.43
Malpractice
0.43

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 45315 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.66× 1.0541.7496
Practice expense5.43× 1.1786.3965
Malpractice0.43× 1.1130.4786
Total RVUs8.6248
Conversion factor× 33.4009

Office rate, Washington, DC area$288.08

Office: (1.66 × 1.054 + 5.43 × 1.178 + 0.43 × 1.113) × $33.4009 = $288.08

Facility: (1.66 × 1.054 + 0.91 × 1.178 + 0.43 × 1.113) × $33.4009 = $110.23

Open 45315 in the RVU calculator

Payment rules and modifiers for 45315

The CMS indicators that decide how 45315 is paid alongside other services.

CMS payment indicators · 45315

Proctosigmoidoscopy, snare removal of lesion

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

45315 without 51 · national office

$251.17

Proctosigmoidoscopy, snare removal of lesion

45315-51 · Second procedure: 50%

$125.59

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 45315

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

Codes related to 45315
CodeHow it relatesOffice range, Washington, DC area
Same family
45300Proctosigmoidoscopy, rigid, diagnosticRigid proctosigmoidoscopy without the snare removal represented by 45315.$171.58
45308Lesion removal, rigid scope, cautery techniqueRigid proctosigmoidoscopy with a different lesion-removal method.$261.53
45309Proctosigmoidoscopy, snare lesion removalAnother rigid proctosigmoidoscopy lesion-removal code; check the documented technique.$269.34
Used instead
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than snare removal.$228.64
45338Flexible sigmoidoscopy, snare lesion removalSnare removal performed through a flexible rather than rigid sigmoidoscope.$385.82

How 45315 has changed in Washington, DC area

45315 · Office / nonfacility

$288.08

Effective 2026-10-01

The base rate is $35.20 higher than on 2025-10-01, moving from $252.88 to $288.08 (13.9%).

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

    $252.88changed to$288.08

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.70 changed to 1.66
    • Practice expense RVU 4.62 changed to 5.43
    • Malpractice RVU 0.44 changed to 0.43
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $263.02changed to$252.88

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.70 changed to 4.62
    • Malpractice RVU 0.43 changed to 0.44

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $258.73changed to$263.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $274.59changed to$258.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.76 changed to 4.70
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $289.55changed to$274.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.88 changed to 4.76
    • Malpractice RVU 0.42 changed to 0.43
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $286.79changed to$289.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.75 changed to 4.88
    • Malpractice RVU 0.43 changed to 0.42

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $251.60changed to$286.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.81 changed to 4.75
    • Malpractice RVU 0.42 changed to 0.43
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $234.67changed to$251.60

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.49 changed to 3.81
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $220.95changed to$234.67

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.19 changed to 3.49
    • Malpractice RVU 0.41 changed to 0.42

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $214.04changed to$220.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.07 changed to 3.19
    • Malpractice RVU 0.38 changed to 0.41
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $268.33changed to$214.04

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.80 changed to 1.70
    • Practice expense RVU 4.49 changed to 3.07
    • Malpractice RVU 0.15 changed to 0.38
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $298.65changed to$268.33

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.86 changed to 4.49
    • Malpractice RVU 0.44 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $297.17changed to$298.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $271.41changed to$297.17

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.41 changed to 4.86
    • Malpractice RVU 0.32 changed to 0.44
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $279.10changed to$271.41

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.96 changed to 4.41
    • Malpractice RVU 0.33 changed to 0.32
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $279.10

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$288.08$110.23RVU26D
2026-07-01$288.08$110.23RVU26C
2026-04-01$288.08$110.23RVU26B
2026-01-01$288.08$110.23RVU26A
2025-10-01$252.88$116.00RVU25D
2025-07-01$252.88$116.00RVU25C
2025-04-01$252.88$116.00RVU25B
2025-01-01$252.88$116.00RVU25A
2024-10-01$263.02$117.80RVU24D
2024-07-01$263.02$117.80RVU24C
2024-04-01$263.02$117.80RVU24B
2024-03-09$263.02$117.80RVU24AR
2024-01-01$258.73$115.88RVU24A
2023-10-01$274.59$120.73RVU23D
2023-07-01$274.59$120.73RVU23C
2023-04-01$274.59$120.73RVU23B
2023-01-01$274.59$120.73RVU23A
2022-10-01$289.55$124.44RVU22D
2022-07-01$289.55$124.44RVU22C
2022-04-01$289.55$124.44RVU22B
2022-01-01$289.55$124.44RVU22A
2021-10-01$286.79$125.06RVU21D
2021-07-01$286.79$125.06RVU21C
2021-04-01$286.79$125.06RVU21B
2021-01-01$286.79$125.06RVU21A
2020-10-01$251.60$126.02RVU20D
2020-07-01$251.60$126.02RVU20C
2020-04-01$251.60$126.02RVU20B
2020-01-01$251.60$126.02RVU20A
2019-10-01$234.67$124.37RVU19D
2019-07-01$234.67$124.37RVU19C
2019-04-01$234.67$124.37RVU19B
2019-01-01$234.67$124.37RVU19A
2018-10-01$220.95$124.21RVU18D
2018-07-01$220.95$124.21RVU18C
2018-04-01$220.95$124.21RVU18B
2018-01-01$220.95$124.21RVU18AR1
2017-10-01$214.04$123.65RVU17D
2017-07-01$214.04$123.65RVU17C
2017-04-01$214.04$123.65RVU17B
2017-01-01$214.04$123.65RVU17A
2016-10-01$268.33$121.20RVU16D
2016-07-01$268.33$121.20RVU16C
2016-04-01$268.33$121.20RVU16B
2016-01-01$268.33$121.20RVU16A
2015-10-01$298.65$131.95RVU15D
2015-07-01$298.65$131.95RVU15C
2015-04-01$297.17$131.29RVU15B
2015-01-01$297.17$131.29RVU15A
2014-10-01$271.41$128.45RVU14D
2014-07-01$271.41$128.45RVU14C
2014-04-01$271.41$128.45RVU14B
2014-01-01$271.41$128.45RVU14A
2013-10-01$279.10$124.21RVU13D
2013-07-01$279.10$124.21RVU13C
2013-04-01$279.10$124.21RVU13B
2013-01-01$279.10$124.21RVU13AR

Price 45315 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

45315 billing questions

How is 45315 distinguished from flexible sigmoidoscopy with snare removal?

Use 45315 when the documented instrument is a rigid proctosigmoidoscope. Flexible sigmoidoscopy with snare removal is reported with 45338.

Is a diagnostic rigid proctosigmoidoscopy separately reported with 45315?

The examination performed as part of the snare removal is included. If another related endoscopy is separately reportable during the same session, CMS endoscopy family pricing applies.

What documentation supports 45315?

The procedure note should identify the rigid scope, the rectal or distal sigmoid lesion, and removal with a snare.

Does the 0-day global period include care on the procedure date?

Yes. Same-day preoperative and postoperative care for this minor procedure is included.

Can modifier 50 or surgical team billing be used for 45315?

Modifier 50 is inappropriate for this anatomy. CMS does not pay an assistant at surgery and does not permit co-surgeons or team surgery for this code.

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 45315PPRRVU2026_Oct_nonQPP.csv, line 5,493 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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