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CPT code 45315: Proctosigmoidoscopy, snare removal of lesion2026 Medicare rate & RVUs in Houston, TX

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 Houston, TX, Medicare pays $255.75 for 45315 in the office and $105.83 when it’s performed in a hospital or facility.

$255.75Office (non-facility)
$105.83Hospital or facility
+1.8%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $255.75. The RVUs are the same everywhere; the geographic indexes change the dollars.

45315 in Houston, TX vs other payment areas
  1. Houston, TX · this page$255.75
  2. Austin, TX · Texas$260.17+$4.42
  3. Beaumont, TX · Texas$233.83−$21.92
  4. Brazoria, TX · Texas$246.83−$8.92
  5. Dallas, TX · Texas$248.91−$6.84
  6. Fort Worth, TX · Texas$247.28−$8.47
  7. Galveston, TX · Texas$247.88−$7.87

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

Every other payment area

45315 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$240.53$97.26
Los Angeles, CACalifornia$281.81$103.21
Washington, DC areaDistrict of Columbia$288.08$110.23
Miami, FLFlorida$280.57$123.41
Chicago, ILIllinois$271.07$119.34
Manhattan, NYNew York$292.52$117.09
AlaskaAlaska$284.24$123.45
AlabamaAlabama$222.27$90.17

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 45315 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.66× 1.0081.6733
Practice expense5.43× 0.9935.3920
Malpractice0.43× 1.3760.5917
Total RVUs7.6570
Conversion factor× 33.4009

Office rate, Houston, TX$255.75

Office: (1.66 × 1.008 + 5.43 × 0.993 + 0.43 × 1.376) × $33.4009 = $255.75

Facility: (1.66 × 1.008 + 0.91 × 0.993 + 0.43 × 1.376) × $33.4009 = $105.83

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, Houston, TX
Same family
45300Proctosigmoidoscopy, rigid, diagnosticRigid proctosigmoidoscopy without the snare removal represented by 45315.$149.65
45308Lesion removal, rigid scope, cautery techniqueRigid proctosigmoidoscopy with a different lesion-removal method.$230.65
45309Proctosigmoidoscopy, snare lesion removalAnother rigid proctosigmoidoscopy lesion-removal code; check the documented technique.$237.92
Used instead
45305Proctosigmoidoscopy, rigid scope with biopsyRigid proctosigmoidoscopy with biopsy rather than snare removal.$200.13
45338Flexible sigmoidoscopy, snare lesion removalSnare removal performed through a flexible rather than rigid sigmoidoscope.$336.87

How 45315 has changed in Houston, TX

45315 · Office / nonfacility

$255.75

Effective 2026-10-01

The base rate is $30.05 higher than on 2025-10-01, moving from $225.70 to $255.75 (13.3%).

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

    $225.70changed to$255.75

    • 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 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $234.47changed to$225.70

    • 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

    $230.64changed to$234.47

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $239.63changed to$230.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.76 changed to 4.70
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $247.57changed to$239.63

    • 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 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $245.27changed to$247.57

    • 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

    $217.11changed to$245.27

    • 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 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $203.95changed to$217.11

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.49 changed to 3.81
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $192.46changed to$203.95

    • 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

    $186.30changed to$192.46

    • 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
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $232.53changed to$186.30

    • 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 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $256.69changed to$232.53

    • 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

    $255.42changed to$256.69

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $234.76changed to$255.42

    • 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 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $241.25changed to$234.76

    • 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 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $241.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$255.75$105.83RVU26D
2026-07-01$255.75$105.83RVU26C
2026-04-01$255.75$105.83RVU26B
2026-01-01$255.75$105.83RVU26A
2025-10-01$225.70$110.53RVU25D
2025-07-01$225.70$110.53RVU25C
2025-04-01$225.70$110.53RVU25B
2025-01-01$225.70$110.53RVU25A
2024-10-01$234.47$112.27RVU24D
2024-07-01$234.47$112.27RVU24C
2024-04-01$234.47$112.27RVU24B
2024-03-09$234.47$112.27RVU24AR
2024-01-01$230.64$110.44RVU24A
2023-10-01$239.63$110.87RVU23D
2023-07-01$239.63$110.87RVU23C
2023-04-01$239.63$110.87RVU23B
2023-01-01$239.63$110.87RVU23A
2022-10-01$247.57$110.12RVU22D
2022-07-01$247.57$110.12RVU22C
2022-04-01$247.57$110.12RVU22B
2022-01-01$247.57$110.12RVU22A
2021-10-01$245.27$110.63RVU21D
2021-07-01$245.27$110.63RVU21C
2021-04-01$245.27$110.63RVU21B
2021-01-01$245.27$110.63RVU21A
2020-10-01$217.11$112.20RVU20D
2020-07-01$217.11$112.20RVU20C
2020-04-01$217.11$112.20RVU20B
2020-01-01$217.11$112.20RVU20A
2019-10-01$203.95$111.31RVU19D
2019-07-01$203.95$111.31RVU19C
2019-04-01$203.95$111.31RVU19B
2019-01-01$203.95$111.31RVU19A
2018-10-01$192.46$111.21RVU18D
2018-07-01$192.46$111.21RVU18C
2018-04-01$192.46$111.21RVU18B
2018-01-01$192.46$111.21RVU18AR1
2017-10-01$186.30$110.62RVU17D
2017-07-01$186.30$110.62RVU17C
2017-04-01$186.30$110.62RVU17B
2017-01-01$186.30$110.62RVU17A
2016-10-01$232.53$109.70RVU16D
2016-07-01$232.53$109.70RVU16C
2016-04-01$232.53$109.70RVU16B
2016-01-01$232.53$109.70RVU16A
2015-10-01$256.69$117.52RVU15D
2015-07-01$256.69$117.52RVU15C
2015-04-01$255.42$116.93RVU15B
2015-01-01$255.42$116.93RVU15A
2014-10-01$234.76$115.35RVU14D
2014-07-01$234.76$115.35RVU14C
2014-04-01$234.76$115.35RVU14B
2014-01-01$234.76$115.35RVU14A
2013-10-01$241.25$111.70RVU13D
2013-07-01$241.25$111.70RVU13C
2013-04-01$241.25$111.70RVU13B
2013-01-01$241.25$111.70RVU13AR

Price 45315 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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