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CPT code 45330: Flexible sigmoidoscopy, diagnostic2026 Medicare rate & RVUs in Iowa

A flexible scope examines the rectum and sigmoid colon to evaluate lower gastrointestinal symptoms when no biopsy or therapeutic procedure is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality45.9K Medicare services in 2024

In Iowa, Medicare pays $197.07 for 45330 in the office and $49.46 when it’s performed in a hospital or facility.

$197.07Office (non-facility)
$49.46Hospital or facility
−8.4%vs the national office rate ($215.10)

Check a contract rate as a % of Medicare · 45330 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 45330 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 45330 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 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.

How Iowa compares for 45330

Across 109 of 109 payment localities, the office rate for 45330 runs from $187.26 in Arkansas to $297.45 in San Benito County, CA. Iowa pays $197.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

45330 in Iowa vs other payment areas
  1. Iowa · this page$197.07
  2. Los Angeles, CA · California$248.50+$51.43
  3. Washington, DC area · District of Columbia$249.73+$52.66
  4. Miami, FL · Florida$228.76+$31.69
  5. Chicago, IL · Illinois$221.40+$24.33
  6. Manhattan, NY · New York$248.96+$51.89
  7. Alaska · Alaska$238.94+$41.87

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

Every other payment area

45330 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$190.40$49.24
ArkansasArkansas$187.26$48.68
ArizonaArizona$208.83$52.50
Bakersfield, CACalifornia$231.69$54.88
Chico, CACalifornia$231.34$54.53
El Centro, CACalifornia$231.36$54.55
Fresno, CACalifornia$231.34$54.53
Hanford, CACalifornia$231.34$54.53

45330 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.

$187.26

$264.40

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

View every state and territory as a table
45330 office rate range by state
State / territoryOffice rate rangeLocalities
AK$238.941
AL$190.401
AR$187.261
AZ$208.831
CA$231.34–$297.4529
CO$226.311
CT$230.641
DC$249.731
DE$212.631
FL$209.03–$228.763
GA$196.03–$218.932
GU$238.581
HI$238.581
IA$197.071
ID$198.291
IL$201.38–$223.354
IN$199.631
KS$195.481
KY$194.371
LA$193.81–$204.812
MA$224.46–$251.422
MD$217.25–$249.733
ME$198.89–$211.972
MI$199.64–$211.422
MN$217.611
MO$189.65–$206.293
MS$188.521
MT$215.091
NC$201.351
ND$212.721
NE$198.461
NH$222.131
NJ$233.49–$246.492
NM$200.661
NV$214.621
NY$204.73–$255.015
OH$199.151
OK$194.551
OR$213.18–$234.912
PA$199.82–$223.902
PR$217.061
RI$221.251
SC$200.541
SD$212.441
TN$196.531
TX$198.28–$225.358
UT$203.671
VA$210.80–$249.732
VI$217.061
VT$211.281
WA$224.24–$257.442
WI$204.611
WV$192.761
WY$214.061

See 45330 in every payment locality

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

Office or facility?

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.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,498

Code
45330
Physician work
0.82
Practice expense
5.50
Malpractice
0.12

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 45330 in Iowa
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0000.8200
Practice expense5.50× 0.9155.0325
Malpractice0.12× 0.3970.0476
Total RVUs5.9001
Conversion factor× 33.4009

Office rate, Iowa$197.07

Office: (0.82 × 1 + 5.5 × 0.915 + 0.12 × 0.397) × $33.4009 = $197.07

Facility: (0.82 × 1 + 0.67 × 0.915 + 0.12 × 0.397) × $33.4009 = $49.46

Open 45330 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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

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%).

When to use modifier 51

Codes related to 45330

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

Codes related to 45330
CodeHow it relatesOffice range, Iowa
Same family
45331Sigmoidoscopy, with biopsyFlexible sigmoidoscopy with biopsy; distinguishes tissue sampling from diagnostic examination alone.$296.26
45332Flexible sigmoidoscopy, foreign body removalFlexible sigmoidoscopy with foreign-body removal rather than diagnostic examination alone.$287.44
45333Flexible sigmoidoscopy, hot biopsy forceps removalFlexible sigmoidoscopy with polyp removal; report the intervention when performed.$337.27
45334Flexible sigmoidoscopy, endoscopic bleeding controlFlexible sigmoidoscopy with treatment of bleeding.$499.58
Used instead
45378Colonoscopy, diagnostic, no tissue removalDiagnostic colonoscopy examines the colon more extensively than flexible sigmoidoscopy.$347.89

How 45330 has changed in Iowa

45330 · Office / nonfacility

$197.07

Effective 2026-10-01

The base rate is $32.13 higher than on 2025-10-01, moving from $164.94 to $197.07 (19.5%).

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

    $164.94changed to$197.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.84 changed to 0.82
    • Practice expense RVU 4.60 changed to 5.50
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $170.50changed to$164.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.63 changed to 4.60
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $167.72changed to$170.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $173.34changed to$167.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.64 changed to 4.63
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $178.84changed to$173.34

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.72 changed to 4.64
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $178.10changed to$178.84

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.65 changed to 4.72

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $163.91changed to$178.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.03 changed to 4.65
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $160.24changed to$163.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.92 changed to 4.03
    • Malpractice RVU 0.12 changed to 0.11
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $157.78changed to$160.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.85 changed to 3.92

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $154.48changed to$157.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.78 changed to 3.85
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $153.46changed to$154.48

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $127.30changed to$153.46

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 0.96 changed to 0.84
    • Practice expense RVU 2.80 changed to 3.78
    • Malpractice RVU 0.15 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $126.67changed to$127.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $125.11changed to$126.67

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.77 changed to 2.80
    • Malpractice RVU 0.13 changed to 0.15
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $130.50changed to$125.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.17 changed to 2.77
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $130.50

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$197.07$49.46RVU26D
2026-07-01$197.07$49.46RVU26C
2026-04-01$197.07$49.46RVU26B
2026-01-01$197.07$49.46RVU26A
2025-10-01$164.94$50.95RVU25D
2025-07-01$164.94$50.95RVU25C
2025-04-01$164.94$50.95RVU25B
2025-01-01$164.94$50.95RVU25A
2024-10-01$170.50$51.97RVU24D
2024-07-01$170.50$51.97RVU24C
2024-04-01$170.50$51.97RVU24B
2024-03-09$170.50$51.97RVU24AR
2024-01-01$167.72$51.12RVU24A
2023-10-01$173.34$51.84RVU23D
2023-07-01$173.34$51.84RVU23C
2023-04-01$173.34$51.84RVU23B
2023-01-01$173.34$51.84RVU23A
2022-10-01$178.84$52.34RVU22D
2022-07-01$178.84$52.34RVU22C
2022-04-01$178.84$52.34RVU22B
2022-01-01$178.84$52.34RVU22A
2021-10-01$178.10$52.15RVU21D
2021-07-01$178.10$52.15RVU21C
2021-04-01$178.10$52.15RVU21B
2021-01-01$178.10$52.15RVU21A
2020-10-01$163.91$53.60RVU20D
2020-07-01$163.91$53.60RVU20C
2020-04-01$163.91$53.60RVU20B
2020-01-01$163.91$53.60RVU20A
2019-10-01$160.24$54.00RVU19D
2019-07-01$160.24$54.00RVU19C
2019-04-01$160.24$54.00RVU19B
2019-01-01$160.24$54.00RVU19A
2018-10-01$157.78$54.27RVU18D
2018-07-01$157.78$54.27RVU18C
2018-04-01$157.78$54.27RVU18B
2018-01-01$157.78$54.27RVU18AR1
2017-10-01$154.48$54.13RVU17D
2017-07-01$154.48$54.13RVU17C
2017-04-01$154.48$54.13RVU17B
2017-01-01$154.48$54.13RVU17A
2016-10-01$153.46$53.69RVU16D
2016-07-01$153.46$53.69RVU16C
2016-04-01$153.46$53.69RVU16B
2016-01-01$153.46$53.69RVU16A
2015-10-01$127.30$60.33RVU15D
2015-07-01$127.30$60.33RVU15C
2015-04-01$126.67$60.03RVU15B
2015-01-01$126.67$60.03RVU15A
2014-10-01$125.11$59.61RVU14D
2014-07-01$125.11$59.61RVU14C
2014-04-01$125.11$59.61RVU14B
2014-01-01$125.11$59.61RVU14A
2013-10-01$130.50$59.58RVU13D
2013-07-01$130.50$59.58RVU13C
2013-04-01$130.50$59.58RVU13B
2013-01-01$130.50$59.58RVU13AR

Price 45330 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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
RVUs for 45330PPRRVU2026_Oct_nonQPP.csv, line 5,498 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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