CPT code 45332: Flexible sigmoidoscopy, foreign body removal2026 Medicare rate & RVUs
Flexible sigmoidoscopy with endoscopic extraction of a foreign object from the rectum or sigmoid colon, reported when removal is performed during the examination.
Medicare pays $312.97 for 45332 nationally in the office and $95.86 in a hospital or facility. Local office rates run $274.41–$425.57.
Medicare rate · 45332
Flexible sigmoidoscopy, foreign body removal
- Work RVUs
- 1.72
- Total RVUs
- 9.37
- Global days
- 000
National rate · 2026
$312.97
Office setting, before claim adjustments.
See every locality for 45332 →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 45332 covers
An endoscopist passes a flexible instrument through the anus to inspect the rectum and sigmoid colon and uses an endoscopic device to retrieve a foreign object encountered there. Gastroenterologists and colorectal surgeons commonly perform the procedure in an endoscopy unit or hospital outpatient setting; urgent removal may occur in a facility when an object is retained or causing symptoms. The report should identify the object and its location, document the scope extent and retrieval method, and describe the outcome or why removal could not be completed.
Report this service for endoscopic foreign-body extraction, not for inspection alone, biopsy, or polyp removal. Documentation should distinguish extraction from treatment of a lesion and identify any other endoscopic service performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Modifier 50 is inappropriate for this descriptor and anatomy. Medicare does not pay an assistant-at-surgery claim for this service under statutory restriction; 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 45332 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
$274.41 to $425.57
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $278.76 | $88.79 |
| Alaska | $354.52 | $123.31 |
| Arizona | $304.22 | $93.84 |
| Arkansas | $274.41 | $87.92 |
| Atlanta, GA | $318.59 | $98.01 |
| Austin, TX | $326.64 | $96.94 |
| Bakersfield, CA | $335.01 | $97.06 |
| Baltimore area, MD | $333.74 | $100.79 |
| Beaumont, TX | $290.11 | $92.54 |
| Brazoria, TX | $309.58 | $94.42 |
| Chicago, IL | $324.13 | $105.93 |
| Chico, CA | $334.36 | $96.41 |
| Colorado | $327.93 | $96.93 |
| Connecticut | $334.77 | $100.94 |
| Dallas, TX | $311.45 | $95.21 |
| Delaware | $309.53 | $95.03 |
| Detroit, MI | $309.32 | $99.81 |
| East St. Louis, IL | $300.56 | $100.83 |
| El Centro, CA | $334.39 | $96.45 |
| Fort Lauderdale, FL | $322.13 | $102.20 |
| Fort Worth, TX | $309.06 | $94.99 |
| Fresno, CA | $334.36 | $96.41 |
| Galveston, TX | $310.42 | $94.84 |
| Hanford, CA | $334.36 | $96.41 |
| Hawaii, Guam, HI | $343.87 | $97.02 |
| Houston, TX | $314.45 | $98.87 |
| Idaho | $289.24 | $89.50 |
| Indiana | $291.07 | $89.82 |
| Iowa | $287.44 | $88.79 |
| Kansas | $285.50 | $89.23 |
| Kentucky | $284.80 | $91.79 |
| King County, WA | $370.83 | $104.44 |
| Los Angeles, CA | $358.27 | $101.43 |
| Madera, CA | $334.36 | $96.41 |
| Manhattan, NY | $361.15 | $108.88 |
| Marin County, CA | $416.20 | $110.08 |
| Merced, CA | $334.36 | $96.41 |
| Metropolitan Boston, MA | $362.66 | $103.43 |
| Metropolitan Kansas City, MO | $297.66 | $93.80 |
| Metropolitan Philadelphia, PA | $325.59 | $99.59 |
| Metropolitan St. Louis, MO | $301.07 | $94.38 |
| Miami, FL | $334.38 | $108.37 |
| Minnesota | $314.99 | $91.59 |
| Mississippi | $276.55 | $89.62 |
| Modesto, CA | $334.36 | $96.41 |
| Montana | $312.95 | $95.85 |
| Napa, CA | $391.89 | $105.74 |
| Nebraska | $289.29 | $88.90 |
| Nevada | $311.99 | $94.66 |
| New Hampshire | $322.22 | $96.22 |
| New Mexico | $293.85 | $94.76 |
| New Orleans, LA | $299.32 | $95.03 |
| North Carolina | $293.69 | $91.13 |
| North Dakota | $308.60 | $91.50 |
| Northern New Jersey | $356.79 | $104.95 |
| NYC suburbs and Long Island, NY | $369.84 | $111.71 |
| Ohio | $291.43 | $93.22 |
| Oklahoma | $284.77 | $90.90 |
| Oxnard, CA | $356.97 | $100.35 |
| Portland, OR | $339.55 | $98.35 |
| Poughkeepsie and northern NYC suburbs, NY | $340.67 | $102.94 |
| Puerto Rico | $315.59 | $96.09 |
| Queens, NY | $365.06 | $108.44 |
| Redding, CA | $334.36 | $96.41 |
| Rest of California | $334.36 | $96.41 |
| Rest of Florida | $305.74 | $98.19 |
| Rest of Georgia | $287.58 | $93.92 |
| Rest of Illinois | $295.51 | $97.30 |
| Rest of Louisiana | $284.12 | $91.98 |
| Rest of Maine | $290.34 | $90.60 |
| Rest of Maryland | $315.92 | $96.21 |
| Rest of Massachusetts | $325.55 | $96.93 |
| Rest of Michigan | $292.32 | $94.11 |
| Rest of Missouri | $278.53 | $91.38 |
| Rest of New Jersey | $338.81 | $101.73 |
| Rest of New York | $298.38 | $92.13 |
| Rest of Oregon | $309.79 | $93.55 |
| Rest of Pennsylvania | $292.21 | $92.91 |
| Rest of Texas | $299.60 | $93.56 |
| Rest of Washington | $325.11 | $96.50 |
| Rhode Island | $321.45 | $97.18 |
| Riverside, CA | $336.74 | $98.80 |
| Sacramento, CA | $352.08 | $99.58 |
| Salinas, CA | $350.80 | $99.17 |
| San Benito County, CA | $425.57 | $112.50 |
| San Diego, CA | $359.97 | $100.31 |
| San Francisco, CA | $415.95 | $109.83 |
| San Luis Obispo, CA | $345.03 | $97.75 |
| Santa Clara County, CA | $424.55 | $111.48 |
| Santa Cruz, CA | $364.12 | $100.34 |
| Santa Maria, CA | $352.36 | $99.22 |
| Santa Rosa, CA | $367.86 | $101.26 |
| South Carolina | $293.00 | $92.40 |
| South Dakota | $308.09 | $90.98 |
| Southern Maine, ME | $308.02 | $92.87 |
| Stockton, CA | $334.36 | $96.41 |
| Suburban Chicago, IL | $325.74 | $102.77 |
| Tennessee | $286.98 | $89.63 |
| Utah | $297.33 | $93.25 |
| Vallejo, CA | $391.53 | $105.38 |
| Vermont | $306.85 | $91.92 |
| Virgin Islands, VI | $315.59 | $96.09 |
| Virginia | $306.59 | $93.17 |
| Visalia, CA | $334.36 | $96.41 |
| Washington, DC area | $361.07 | $105.32 |
| West Virginia | $283.62 | $94.96 |
| Wisconsin | $297.46 | $89.47 |
| Wyoming | $311.06 | $93.95 |
| Yuba City, CA | $334.36 | $96.41 |
45332 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.
$274.41
$379.97
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 | $354.52 | 1 |
| AL | $278.76 | 1 |
| AR | $274.41 | 1 |
| AZ | $304.22 | 1 |
| CA | $334.36–$425.57 | 29 |
| CO | $327.93 | 1 |
| CT | $334.77 | 1 |
| DC | $361.07 | 1 |
| DE | $309.53 | 1 |
| FL | $305.74–$334.38 | 3 |
| GA | $287.58–$318.59 | 2 |
| GU | $343.87 | 1 |
| HI | $343.87 | 1 |
| IA | $287.44 | 1 |
| ID | $289.24 | 1 |
| IL | $295.51–$325.74 | 4 |
| IN | $291.07 | 1 |
| KS | $285.50 | 1 |
| KY | $284.80 | 1 |
| LA | $284.12–$299.32 | 2 |
| MA | $325.55–$362.66 | 2 |
| MD | $315.92–$361.07 | 3 |
| ME | $290.34–$308.02 | 2 |
| MI | $292.32–$309.32 | 2 |
| MN | $314.99 | 1 |
| MO | $278.53–$301.07 | 3 |
| MS | $276.55 | 1 |
| MT | $312.95 | 1 |
| NC | $293.69 | 1 |
| ND | $308.60 | 1 |
| NE | $289.29 | 1 |
| NH | $322.22 | 1 |
| NJ | $338.81–$356.79 | 2 |
| NM | $293.85 | 1 |
| NV | $311.99 | 1 |
| NY | $298.38–$369.84 | 5 |
| OH | $291.43 | 1 |
| OK | $284.77 | 1 |
| OR | $309.79–$339.55 | 2 |
| PA | $292.21–$325.59 | 2 |
| PR | $315.59 | 1 |
| RI | $321.45 | 1 |
| SC | $293.00 | 1 |
| SD | $308.09 | 1 |
| TN | $286.98 | 1 |
| TX | $290.11–$326.64 | 8 |
| UT | $297.33 | 1 |
| VA | $306.59–$361.07 | 2 |
| VI | $315.59 | 1 |
| VT | $306.85 | 1 |
| WA | $325.11–$370.83 | 2 |
| WI | $297.46 | 1 |
| WV | $283.62 | 1 |
| WY | $311.06 | 1 |
How the 45332 rate is calculated
Each of 45332’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 · 45332
RVUs × geographic indexes × conversion factor
Work1.72
1.72 RVUs× 1.000 GPCI
Practice expense7.43
7.43 RVUs× 1.000 GPCI
Malpractice0.22
0.22 RVUs× 1.000 GPCI
Adjusted RVUs
9.3700
Conversion factor
$33.4009
Medicare rate
$312.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45332
The CMS indicators that decide how 45332 is paid alongside other services.
CMS payment indicators · 45332
Flexible sigmoidoscopy, foreign body removal
| 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
45332 without 51 · national office
$312.97
Flexible sigmoidoscopy, foreign body removal
45332-51 · Second procedure: 50%
$156.49
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%).
45332 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45307Foreign body removalRigid proctosigmoidoscopy
- Use 45332 when the removal is performed with a flexible sigmoidoscope; 45307 describes rigid proctosigmoidoscopy with foreign-body removal.
- 45330Flexible sigmoidoscopyDiagnostic
- 45330 is for diagnostic flexible sigmoidoscopy without a therapeutic removal. Use 45332 when the endoscopic service includes foreign-body extraction.
- 45331SigmoidoscopyWith biopsy
- 45331 describes flexible sigmoidoscopy with biopsy. It is not the code for retrieving a foreign object.
- 45333Flexible sigmoidoscopyHot biopsy forceps removal
- 45333 describes flexible sigmoidoscopy with polyp removal. Use 45332 for foreign-body extraction rather than removal of a polyp.
45332 billing questions
How does this differ from rigid proctosigmoidoscopy with foreign-body removal?
This code describes removal using a flexible sigmoidoscope. The rigid proctosigmoidoscopy code is the alternative when the documented procedure uses a rigid instrument.
Can diagnostic inspection be reported separately?
The inspection is part of the therapeutic endoscopic service when it accompanies foreign-body removal. Use a diagnostic-only code when no removal or other therapeutic service is performed.
Can a biopsy or polypectomy be reported instead?
No. Biopsy and polyp removal are distinct services with their own flexible sigmoidoscopy codes; select the code that matches the work documented.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this descriptor and anatomy.
How does Medicare price related endoscopies performed at the same session?
CMS applies endoscopy-family pricing when related endoscopies are performed together. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
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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