CPT code 45317: Bleeding control, rigid proctosigmoidoscopy2026 Medicare rate & RVUs in Texas
Reports rigid proctosigmoidoscopy used to locate and treat active bleeding in the rectum or distal sigmoid with endoscopic hemostasis.
Medicare pays $224.29–$248.90 for 45317 in the office in Texas, from Beaumont, TX to Austin, TX. 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.
Your location
On this page 9 sections
What 45317 covers
A clinician advances a rigid proctosigmoidoscope through the anus to examine the rectum and distal sigmoid and treat a bleeding site. A gastroenterologist or colorectal surgeon may perform the service in an office, outpatient endoscopy unit, or hospital setting. Hemostasis may use an endoscopic technique such as cautery, injection, or another method suited to the bleeding source.
Report this code when the rigid examination includes active treatment to control bleeding, rather than a diagnostic examination alone. The procedure note should identify the bleeding site, the intervention used, and the result. 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. Bilateral adjustment is inappropriate; assistant-at-surgery payment is statutorily restricted, and 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.
Where 45317 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$224.29 to $248.90
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $248.90 | $103.30 |
| Beaumont, TX | $224.29 | $99.06 |
| Brazoria, TX | $236.93 | $100.55 |
| Dallas, TX | $238.61 | $101.55 |
| Fort Worth, TX | $237.06 | $101.37 |
| Galveston, TX | $237.74 | $101.10 |
| Houston, TX | $243.24 | $106.59 |
| Rest of Texas | $230.60 | $100.00 |
How the 45317 rate is calculated
Each of 45317’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 · 45317
RVUs × geographic indexes × conversion factor
Work1.85
1.85 RVUs× 1.000 GPCI
Practice expense5.04
5.04 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
7.1900
Conversion factor
$33.4009
Medicare rate
$240.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45317
The CMS indicators that decide how 45317 is paid alongside other services.
CMS payment indicators · 45317
Bleeding control, rigid proctosigmoidoscopy
| 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
45317 without 51 · national office
$240.15
Bleeding control, rigid proctosigmoidoscopy
45317-51 · Second procedure: 50%
$120.08
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%).
45317 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45300ProctosigmoidoscopyRigid, diagnostic
- 45300 describes a rigid diagnostic examination. 45317 is appropriate when the examination includes endoscopic treatment to control bleeding.
- 45334Flexible sigmoidoscopyEndoscopic bleeding control
- 45334 is the flexible sigmoidoscopy counterpart for bleeding control. Select the code that matches the instrument used and the examination documented.
- 45320ProctosigmoidoscopyLesion ablation
- 45320 identifies rigid proctosigmoidoscopy with ablation. Use 45317 when the documented service is control of bleeding rather than ablation.
45317 billing questions
How is this different from diagnostic proctosigmoidoscopy?
45317 includes endoscopic treatment to control bleeding. Use the diagnostic code when the rigid examination is performed without bleeding-control treatment.
How does this differ from 45334?
Both address endoscopic control of bleeding, but 45317 is for rigid proctosigmoidoscopy and 45334 is for flexible sigmoidoscopy. Choose according to the instrument and examination documented.
Can the diagnostic examination be billed separately?
The diagnostic examination that leads to bleeding-control treatment is part of the therapeutic endoscopy. Document the treatment performed and the bleeding site.
Should modifier 50 be appended?
No. The anatomy and service make bilateral adjustment inappropriate.
What happens when another related endoscopy is performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. Document each procedure and its distinct clinical purpose.
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
Fee sheets
Put 45317 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet