CPT code 45315: Proctosigmoidoscopy, snare removal of lesion2026 Medicare rate & RVUs in Missouri
Report this service when a clinician uses a rigid proctosigmoidoscope to remove a rectal or distal sigmoid polyp or other lesion with a snare.
Medicare pays $225.77–$242.50 for 45315 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
Where 45315 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$225.77 to $242.50
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $239.78 | $98.02 |
| Metropolitan St. Louis, MO | $242.50 | $98.77 |
| Rest of Missouri | $225.77 | $95.63 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
45315 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45338Flexible sigmoidoscopySnare lesion removal
- Both involve snare removal, but 45315 uses a rigid proctosigmoidoscope; 45338 uses a flexible sigmoidoscope.
- 45305ProctosigmoidoscopyRigid scope with biopsy
- Choose 45305 for a biopsy through a rigid proctosigmoidoscope, rather than removal of a lesion with a snare.
- 45300ProctosigmoidoscopyRigid, diagnostic
- 45300 represents the diagnostic rigid examination. Use 45315 when that examination includes documented snare removal.
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
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