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CPT code 45332: Flexible sigmoidoscopy, foreign body removal2026 Medicare rate & RVUs in Alaska

Flexible sigmoidoscopy with endoscopic extraction of a foreign object from the rectum or sigmoid colon, reported when removal is performed during the examination.

CMS RVU26DEffective Oct 1, 2026One payment locality331 Medicare services in 2024

In Alaska, Medicare pays $354.52 for 45332 in the office and $123.31 when it’s performed in a hospital or facility.

$354.52Office (non-facility)
$123.31Hospital or facility
+13.3%vs the national office rate ($312.97)

Check a contract rate as a % of Medicare · 45332 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 45332 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alaska
  2. What 45332 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 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.

How Alaska compares for 45332

Across 109 of 109 payment localities, the office rate for 45332 runs from $274.41 in Arkansas to $425.57 in San Benito County, CA. Alaska pays $354.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

45332 in Alaska vs other payment areas
  1. Alaska · this page$354.52
  2. Los Angeles, CA · California$358.27+$3.75
  3. Washington, DC area · District of Columbia$361.07+$6.55
  4. Miami, FL · Florida$334.38−$20.14
  5. Chicago, IL · Illinois$324.13−$30.39
  6. Manhattan, NY · New York$361.15+$6.63
  7. Alabama · Alabama$278.76−$75.76

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

Every other payment area

45332 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$274.41$87.92
ArizonaArizona$304.22$93.84
Bakersfield, CACalifornia$335.01$97.06
Chico, CACalifornia$334.36$96.41
El Centro, CACalifornia$334.39$96.45
Fresno, CACalifornia$334.36$96.41
Hanford, CACalifornia$334.36$96.41
Madera, CACalifornia$334.36$96.41

45332 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.

$274.41

$379.97

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

View every state and territory as a table
45332 office rate range by state
State / territoryOffice rate rangeLocalities
AK$354.521
AL$278.761
AR$274.411
AZ$304.221
CA$334.36–$425.5729
CO$327.931
CT$334.771
DC$361.071
DE$309.531
FL$305.74–$334.383
GA$287.58–$318.592
GU$343.871
HI$343.871
IA$287.441
ID$289.241
IL$295.51–$325.744
IN$291.071
KS$285.501
KY$284.801
LA$284.12–$299.322
MA$325.55–$362.662
MD$315.92–$361.073
ME$290.34–$308.022
MI$292.32–$309.322
MN$314.991
MO$278.53–$301.073
MS$276.551
MT$312.951
NC$293.691
ND$308.601
NE$289.291
NH$322.221
NJ$338.81–$356.792
NM$293.851
NV$311.991
NY$298.38–$369.845
OH$291.431
OK$284.771
OR$309.79–$339.552
PA$292.21–$325.592
PR$315.591
RI$321.451
SC$293.001
SD$308.091
TN$286.981
TX$290.11–$326.648
UT$297.331
VA$306.59–$361.072
VI$315.591
VT$306.851
WA$325.11–$370.832
WI$297.461
WV$283.621
WY$311.061

See 45332 in every payment locality

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

Office or facility?

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.

The exact Alaska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,500

Code
45332
Physician work
1.72
Practice expense
7.43
Malpractice
0.22

GPCI2026.csv

5

Locality
Alaska
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Office calculation for 45332 in Alaska
ComponentRVULocality factorAdjusted
Physician work1.72× 1.5002.5800
Practice expense7.43× 1.0657.9129
Malpractice0.22× 0.5510.1212
Total RVUs10.6142
Conversion factor× 33.4009

Office rate, Alaska$354.52

Office: (1.72 × 1.5 + 7.43 × 1.065 + 0.22 × 0.551) × $33.4009 = $354.52

Facility: (1.72 × 1.5 + 0.93 × 1.065 + 0.22 × 0.551) × $33.4009 = $123.31

Open 45332 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 45332

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

Codes related to 45332
CodeHow it relatesOffice range, Alaska
Used instead
45307Foreign body removal, rigid proctosigmoidoscopyRigid proctosigmoidoscopy alternative for endoscopic foreign-body removal.$267.30
Same family
45330Flexible sigmoidoscopy, diagnosticFlexible sigmoidoscopy for diagnostic examination without therapeutic removal.$238.94
45331Sigmoidoscopy, with biopsyFlexible sigmoidoscopy with biopsy rather than foreign-body extraction.$357.70
45333Flexible sigmoidoscopy, hot biopsy forceps removalFlexible sigmoidoscopy with polyp removal rather than foreign-body extraction.$410.17

How 45332 has changed in Alaska

45332 · Office / nonfacility

$354.52

Effective 2026-10-01

The base rate is $47.58 higher than on 2025-10-01, moving from $306.94 to $354.52 (15.5%).

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

    $306.94changed to$354.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.76 changed to 1.72
    • Practice expense RVU 6.21 changed to 7.43
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 1.081 changed to 1.065
    • Malpractice GPCI 0.592 changed to 0.551

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $320.03changed to$306.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.32 changed to 6.21
    • Malpractice RVU 0.24 changed to 0.23

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $314.80changed to$320.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $330.49changed to$314.80

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.34 changed to 6.32
    • Malpractice RVU 0.23 changed to 0.24
    • Practice expense GPCI 1.100 changed to 1.081
    • Malpractice GPCI 0.603 changed to 0.592

  5. January 1, 2023

    RVU23A

    $348.12changed to$330.49

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.51 changed to 6.34
    • Practice expense GPCI 1.118 changed to 1.100
    • Malpractice GPCI 0.614 changed to 0.603

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $346.50changed to$348.12

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.40 changed to 6.51
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $324.53changed to$346.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.54 changed to 6.40
    • Malpractice RVU 0.24 changed to 0.22
    • Malpractice GPCI 0.661 changed to 0.614

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $316.74changed to$324.53

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.34 changed to 5.54
    • Malpractice RVU 0.26 changed to 0.24
    • Practice expense GPCI 1.117 changed to 1.118
    • Malpractice GPCI 0.708 changed to 0.661

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $309.56changed to$316.74

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.17 changed to 5.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $305.30changed to$309.56

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.11 changed to 5.17
    • Practice expense GPCI 1.112 changed to 1.117
    • Malpractice GPCI 0.710 changed to 0.708

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $371.80changed to$305.30

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.86 changed to 1.76
    • Practice expense RVU 6.68 changed to 5.11
    • Malpractice RVU 0.28 changed to 0.26
    • Practice expense GPCI 1.107 changed to 1.112
    • Malpractice GPCI 0.712 changed to 0.710

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $352.12changed to$371.80

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 1.79 changed to 1.86
    • Practice expense RVU 6.24 changed to 6.68
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $350.37changed to$352.12

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $344.50changed to$350.37

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.20 changed to 6.24
    • Malpractice RVU 0.28 changed to 0.29
    • Practice expense GPCI 1.087 changed to 1.107
    • Malpractice GPCI 0.687 changed to 0.712

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $356.71changed to$344.50

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.13 changed to 6.20
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 1.067 changed to 1.087
    • Malpractice GPCI 0.661 changed to 0.687

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $356.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$354.52$123.31RVU26D
2026-07-01$354.52$123.31RVU26C
2026-04-01$354.52$123.31RVU26B
2026-01-01$354.52$123.31RVU26A
2025-10-01$306.94$129.66RVU25D
2025-07-01$306.94$129.66RVU25C
2025-04-01$306.94$129.66RVU25B
2025-01-01$306.94$129.66RVU25A
2024-10-01$320.03$133.27RVU24D
2024-07-01$320.03$133.27RVU24C
2024-04-01$320.03$133.27RVU24B
2024-03-09$320.03$133.27RVU24AR
2024-01-01$314.80$131.10RVU24A
2023-10-01$330.49$134.79RVU23D
2023-07-01$330.49$134.79RVU23C
2023-04-01$330.49$134.79RVU23B
2023-01-01$330.49$134.79RVU23A
2022-10-01$348.12$138.42RVU22D
2022-07-01$348.12$138.42RVU22C
2022-04-01$348.12$138.42RVU22B
2022-01-01$348.12$138.42RVU22A
2021-10-01$346.50$138.57RVU21D
2021-07-01$346.50$138.57RVU21C
2021-04-01$346.50$138.57RVU21B
2021-01-01$346.50$138.57RVU21A
2020-10-01$324.53$142.96RVU20D
2020-07-01$324.53$142.96RVU20C
2020-04-01$324.53$142.96RVU20B
2020-01-01$324.53$142.96RVU20A
2019-10-01$316.74$143.64RVU19D
2019-07-01$316.74$143.64RVU19C
2019-04-01$316.74$143.64RVU19B
2019-01-01$316.74$143.64RVU19A
2018-10-01$309.56$144.29RVU18D
2018-07-01$309.56$144.29RVU18C
2018-04-01$309.56$144.29RVU18B
2018-01-01$309.56$144.29RVU18AR1
2017-10-01$305.30$144.07RVU17D
2017-07-01$305.30$144.07RVU17C
2017-04-01$305.30$144.07RVU17B
2017-01-01$305.30$144.07RVU17A
2016-10-01$371.80$150.63RVU16D
2016-07-01$371.80$150.63RVU16C
2016-04-01$371.80$150.63RVU16B
2016-01-01$371.80$150.63RVU16A
2015-10-01$352.12$147.66RVU15D
2015-07-01$352.12$147.66RVU15C
2015-04-01$350.37$146.92RVU15B
2015-01-01$350.37$146.92RVU15A
2014-10-01$344.50$146.69RVU14D
2014-07-01$344.50$146.69RVU14C
2014-04-01$344.50$146.69RVU14B
2014-01-01$344.50$146.69RVU14A
2013-10-01$356.71$143.61RVU13D
2013-07-01$356.71$143.61RVU13C
2013-04-01$356.71$143.61RVU13B
2013-01-01$356.71$143.61RVU13AR

Price 45332 for an earlier date of service

Where the Alaska rate applies

Alaska is a Medicare payment area, not a city. Our Census mapping connects it to 355 cities and communities in Alaska. Some span more than one payment area; confirm with the service ZIP.

  • Adak
  • Akhiok
  • Akiachak
  • Akiak
  • Akutan
  • Alakanuk
  • Alatna
  • Alcan Border

Browse all communities in Alaska

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
RVUs for 45332PPRRVU2026_Oct_nonQPP.csv, line 5,500 (RVU26D)
Geographic factors for AlaskaGPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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