CPT code 45330: Flexible sigmoidoscopy, diagnostic2026 Medicare rate & RVUs
A flexible scope examines the rectum and sigmoid colon to evaluate lower gastrointestinal symptoms when no biopsy or therapeutic procedure is performed.
Medicare pays $215.10 for 45330 nationally in the office and $53.78 in a hospital or facility. Local office rates run $187.26–$297.45.
Medicare rate · 45330
Flexible sigmoidoscopy, diagnostic
- Work RVUs
- 0.82
- Total RVUs
- 6.44
- Global days
- 000
National rate · 2026
$215.10
Office setting, before claim adjustments.
See every locality for 45330 →Billed by an NP, PA or therapist? →
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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On this page 10 sections
What 45330 covers
A physician, commonly a gastroenterologist or colorectal surgeon, advances a flexible endoscope through the anus to inspect the rectum and sigmoid colon. The service is used to evaluate concerns such as rectal bleeding, altered bowel habits, or suspected distal-colon disease. Specimens collected by brushing or washing are included when performed; the code represents a diagnostic examination, not a tissue biopsy or lesion treatment.
Report 45330 when the examination is diagnostic and no separately coded intervention is performed. The report should support the indication, the portion of bowel examined, and the findings; document any brushing or washing when performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 45330 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$187.26 to $297.45
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $190.40 | $49.24 |
| Alaska | $238.94 | $67.12 |
| Arizona | $208.83 | $52.50 |
| Arkansas | $187.26 | $48.68 |
| Atlanta, GA | $218.93 | $55.02 |
| Austin, TX | $225.35 | $54.67 |
| Bakersfield, CA | $231.69 | $54.88 |
| Baltimore area, MD | $229.90 | $56.80 |
| Beaumont, TX | $198.28 | $51.48 |
| Brazoria, TX | $212.79 | $52.91 |
| Chicago, IL | $221.40 | $59.27 |
| Chico, CA | $231.34 | $54.53 |
| Colorado | $226.31 | $54.66 |
| Connecticut | $230.64 | $56.89 |
| Dallas, TX | $214.04 | $53.36 |
| Delaware | $212.63 | $53.24 |
| Detroit, MI | $211.42 | $55.74 |
| East St. Louis, IL | $204.47 | $56.05 |
| El Centro, CA | $231.36 | $54.55 |
| Fort Lauderdale, FL | $220.73 | $57.30 |
| Fort Worth, TX | $212.26 | $53.19 |
| Fresno, CA | $231.34 | $54.53 |
| Galveston, TX | $213.35 | $53.15 |
| Hanford, CA | $231.34 | $54.53 |
| Hawaii, Guam, HI | $238.58 | $55.15 |
| Houston, TX | $215.54 | $55.34 |
| Idaho | $198.29 | $49.87 |
| Indiana | $199.63 | $50.08 |
| Iowa | $197.07 | $49.46 |
| Kansas | $195.48 | $49.64 |
| Kentucky | $194.37 | $50.95 |
| King County, WA | $257.44 | $59.49 |
| Los Angeles, CA | $248.50 | $57.65 |
| Madera, CA | $231.34 | $54.53 |
| Manhattan, NY | $248.96 | $61.50 |
| Marin County, CA | $290.85 | $63.38 |
| Merced, CA | $231.34 | $54.53 |
| Metropolitan Boston, MA | $251.42 | $58.80 |
| Metropolitan Kansas City, MO | $203.80 | $52.32 |
| Metropolitan Philadelphia, PA | $223.90 | $55.96 |
| Metropolitan St. Louis, MO | $206.29 | $52.71 |
| Miami, FL | $228.76 | $60.82 |
| Minnesota | $217.61 | $51.60 |
| Mississippi | $188.52 | $49.62 |
| Modesto, CA | $231.34 | $54.53 |
| Montana | $215.09 | $53.77 |
| Napa, CA | $273.27 | $60.65 |
| Nebraska | $198.46 | $49.56 |
| Nevada | $214.62 | $53.13 |
| New Hampshire | $222.13 | $54.19 |
| New Mexico | $200.66 | $52.72 |
| New Orleans, LA | $204.81 | $53.00 |
| North Carolina | $201.35 | $50.83 |
| North Dakota | $212.72 | $51.39 |
| Northern New Jersey | $246.49 | $59.35 |
| NYC suburbs and Long Island, NY | $255.01 | $63.19 |
| Ohio | $199.15 | $51.86 |
| Oklahoma | $194.55 | $50.49 |
| Oxnard, CA | $247.79 | $57.10 |
| Portland, OR | $234.91 | $55.67 |
| Poughkeepsie and northern NYC suburbs, NY | $234.63 | $57.98 |
| Puerto Rico | $217.06 | $53.96 |
| Queens, NY | $252.06 | $61.37 |
| Redding, CA | $231.34 | $54.53 |
| Rest of California | $231.34 | $54.53 |
| Rest of Florida | $209.03 | $54.81 |
| Rest of Georgia | $196.03 | $52.13 |
| Rest of Illinois | $201.38 | $54.09 |
| Rest of Louisiana | $193.81 | $51.03 |
| Rest of Maine | $198.89 | $50.47 |
| Rest of Maryland | $217.25 | $53.99 |
| Rest of Massachusetts | $224.46 | $54.59 |
| Rest of Michigan | $199.64 | $52.35 |
| Rest of Missouri | $189.65 | $50.58 |
| Rest of New Jersey | $233.49 | $57.32 |
| Rest of New York | $204.73 | $51.47 |
| Rest of Oregon | $213.18 | $52.50 |
| Rest of Pennsylvania | $199.82 | $51.72 |
| Rest of Texas | $205.34 | $52.25 |
| Rest of Washington | $224.24 | $54.36 |
| Rhode Island | $221.25 | $54.60 |
| Riverside, CA | $232.64 | $55.83 |
| Sacramento, CA | $244.17 | $56.55 |
| Salinas, CA | $243.30 | $56.32 |
| San Benito County, CA | $297.45 | $64.82 |
| San Diego, CA | $250.09 | $57.15 |
| San Francisco, CA | $290.72 | $63.25 |
| San Luis Obispo, CA | $239.24 | $55.49 |
| Santa Clara County, CA | $296.90 | $64.26 |
| Santa Cruz, CA | $253.31 | $57.30 |
| Santa Maria, CA | $244.50 | $56.40 |
| Santa Rosa, CA | $255.95 | $57.84 |
| South Carolina | $200.54 | $51.47 |
| South Dakota | $212.44 | $51.11 |
| Southern Maine, ME | $211.97 | $52.10 |
| Stockton, CA | $231.34 | $54.53 |
| Suburban Chicago, IL | $223.35 | $57.67 |
| Tennessee | $196.53 | $49.88 |
| Utah | $203.67 | $52.02 |
| Vallejo, CA | $273.08 | $60.45 |
| Vermont | $211.28 | $51.57 |
| Virgin Islands, VI | $217.06 | $53.96 |
| Virginia | $210.80 | $52.22 |
| Visalia, CA | $231.34 | $54.53 |
| Washington, DC area | $249.73 | $59.69 |
| West Virginia | $192.76 | $52.57 |
| Wisconsin | $204.61 | $50.06 |
| Wyoming | $214.06 | $52.73 |
| Yuba City, CA | $231.34 | $54.53 |
45330 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$187.26
$264.40
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $238.94 | 1 |
| AL | $190.40 | 1 |
| AR | $187.26 | 1 |
| AZ | $208.83 | 1 |
| CA | $231.34–$297.45 | 29 |
| CO | $226.31 | 1 |
| CT | $230.64 | 1 |
| DC | $249.73 | 1 |
| DE | $212.63 | 1 |
| FL | $209.03–$228.76 | 3 |
| GA | $196.03–$218.93 | 2 |
| GU | $238.58 | 1 |
| HI | $238.58 | 1 |
| IA | $197.07 | 1 |
| ID | $198.29 | 1 |
| IL | $201.38–$223.35 | 4 |
| IN | $199.63 | 1 |
| KS | $195.48 | 1 |
| KY | $194.37 | 1 |
| LA | $193.81–$204.81 | 2 |
| MA | $224.46–$251.42 | 2 |
| MD | $217.25–$249.73 | 3 |
| ME | $198.89–$211.97 | 2 |
| MI | $199.64–$211.42 | 2 |
| MN | $217.61 | 1 |
| MO | $189.65–$206.29 | 3 |
| MS | $188.52 | 1 |
| MT | $215.09 | 1 |
| NC | $201.35 | 1 |
| ND | $212.72 | 1 |
| NE | $198.46 | 1 |
| NH | $222.13 | 1 |
| NJ | $233.49–$246.49 | 2 |
| NM | $200.66 | 1 |
| NV | $214.62 | 1 |
| NY | $204.73–$255.01 | 5 |
| OH | $199.15 | 1 |
| OK | $194.55 | 1 |
| OR | $213.18–$234.91 | 2 |
| PA | $199.82–$223.90 | 2 |
| PR | $217.06 | 1 |
| RI | $221.25 | 1 |
| SC | $200.54 | 1 |
| SD | $212.44 | 1 |
| TN | $196.53 | 1 |
| TX | $198.28–$225.35 | 8 |
| UT | $203.67 | 1 |
| VA | $210.80–$249.73 | 2 |
| VI | $217.06 | 1 |
| VT | $211.28 | 1 |
| WA | $224.24–$257.44 | 2 |
| WI | $204.61 | 1 |
| WV | $192.76 | 1 |
| WY | $214.06 | 1 |
How the 45330 rate is calculated
Each of 45330’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 · 45330
RVUs × geographic indexes × conversion factor
Work0.82
0.82 RVUs× 1.000 GPCI
Practice expense5.50
5.50 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
6.4400
Conversion factor
$33.4009
Medicare rate
$215.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45330
The CMS indicators that decide how 45330 is paid alongside other services.
CMS payment indicators · 45330
Flexible sigmoidoscopy, diagnostic
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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
45330 without 51 · national office
$215.10
Flexible sigmoidoscopy, diagnostic
45330-51 · Second procedure: 50%
$107.55
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%).
45330 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45331SigmoidoscopyWith biopsy
- 45330 is diagnostic, with brushing or washing included when performed. Use 45331 when the flexible sigmoidoscopy includes a tissue biopsy.
- 45333Flexible sigmoidoscopyHot biopsy forceps removal
- 45330 describes diagnostic inspection without lesion removal. Use 45333 when a polyp is removed during flexible sigmoidoscopy.
- 45378ColonoscopyDiagnostic, no tissue removal
- 45330 examines the rectum and sigmoid colon with a flexible scope; 45378 is a diagnostic colonoscopy with a broader colonic examination.
45330 billing questions
When should 45330 be reported instead of 45331?
Use 45330 for a diagnostic examination without tissue biopsy. When the physician obtains a biopsy during flexible sigmoidoscopy, report the biopsy service, 45331, rather than the diagnostic-only code.
Are brushing and washing separately billable?
No. Specimen collection by brushing or washing is included in 45330 when performed. A tissue biopsy or therapeutic maneuver is a different service.
Can 45330 be billed with a polypectomy code for the same examination?
When the same sigmoidoscopy includes polyp removal, report the applicable intervention code rather than separately reporting the diagnostic examination as 45330.
Should modifier 50 be appended for examination of both sides?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the sigmoidoscopy service.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, Medicare pays the highest-valued procedure in full and pays the other procedures at 50%.
What documentation supports 45330?
Document the diagnostic reason, scope examination and extent, findings, and any brushing or washing. If biopsy or treatment is performed, document that work and report the applicable procedure 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
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