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

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 Salinas, CA, Medicare pays $350.80 for 45332 in the office and $99.17 when it’s performed in a hospital or facility.

$350.80Office (non-facility)
$99.17Hospital or facility
+12.1%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 Salinas, CA
  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 Salinas, CA 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. Salinas, CA pays $350.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

45332 in Salinas, CA vs other payment areas
  1. Salinas, CA · this page$350.80
  2. Bakersfield, CA · California$335.01−$15.79
  3. Chico, CA · California$334.36−$16.44
  4. El Centro, CA · California$334.39−$16.41
  5. Fresno, CA · California$334.36−$16.44
  6. Hanford, CA · California$334.36−$16.44
  7. Los Angeles, CA · California$358.27+$7.47

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

Every other payment area

45332 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$334.36$96.41
Merced, CACalifornia$334.36$96.41
Modesto, CACalifornia$334.36$96.41
Napa, CACalifornia$391.89$105.74
Oxnard, CACalifornia$356.97$100.35
Redding, CACalifornia$334.36$96.41
Rest of CaliforniaCalifornia$334.36$96.41
Riverside, CACalifornia$336.74$98.80

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
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 Salinas, CA 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

22

Locality
Salinas, CA
Physician work
1.031
Practice expense
1.159
Malpractice
0.536
Office calculation for 45332 in Salinas, CA
ComponentRVULocality factorAdjusted
Physician work1.72× 1.0311.7733
Practice expense7.43× 1.1598.6114
Malpractice0.22× 0.5360.1179
Total RVUs10.5026
Conversion factor× 33.4009

Office rate, Salinas, CA$350.80

Office: (1.72 × 1.031 + 7.43 × 1.159 + 0.22 × 0.536) × $33.4009 = $350.80

Facility: (1.72 × 1.031 + 0.93 × 1.159 + 0.22 × 0.536) × $33.4009 = $99.17

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

How 45332 has changed in Salinas, CA

45332 · Office / nonfacility

$350.80

Effective 2026-10-01

The base rate is $53.70 higher than on 2025-10-01, moving from $297.10 to $350.80 (18.1%).

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

    $297.10changed to$350.80

    • 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
    • Work GPCI 1.035 changed to 1.031
    • Practice expense GPCI 1.165 changed to 1.159
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $310.20changed to$297.10

    • 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

    $305.14changed to$310.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $313.99changed to$305.14

    • 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
    • Work GPCI 1.050 changed to 1.035
    • Practice expense GPCI 1.149 changed to 1.165
    • Malpractice GPCI 0.579 changed to 0.560
  5. January 1, 2023

    RVU23A

    $324.81changed to$313.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.51 changed to 6.34
    • Work GPCI 1.064 changed to 1.050
    • Practice expense GPCI 1.133 changed to 1.149
    • Malpractice GPCI 0.597 changed to 0.579

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $320.12changed to$324.81

    • 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
    • Work GPCI 1.058 changed to 1.064
    • Practice expense GPCI 1.122 changed to 1.133

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $294.11changed to$320.12

    • 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
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.112 changed to 1.122
    • Malpractice GPCI 0.580 changed to 0.597

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $282.23changed to$294.11

    • 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
    • Work GPCI 1.026 changed to 1.051
    • Practice expense GPCI 1.101 changed to 1.112
    • Malpractice GPCI 0.562 changed to 0.580

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $273.38changed to$282.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.17 changed to 5.34
    • Work GPCI 1.024 changed to 1.026
    • Practice expense GPCI 1.092 changed to 1.101

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $268.98changed to$273.38

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.11 changed to 5.17
    • Practice expense GPCI 1.083 changed to 1.092
    • Malpractice GPCI 0.610 changed to 0.562

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$268.98

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$350.80$99.17RVU26D
2026-07-01$350.80$99.17RVU26C
2026-04-01$350.80$99.17RVU26B
2026-01-01$350.80$99.17RVU26A
2025-10-01$297.10$106.05RVU25D
2025-07-01$297.10$106.05RVU25C
2025-04-01$297.10$106.05RVU25B
2025-01-01$297.10$106.05RVU25A
2024-10-01$310.20$108.93RVU24D
2024-07-01$310.20$108.93RVU24C
2024-04-01$310.20$108.93RVU24B
2024-03-09$310.20$108.93RVU24AR
2024-01-01$305.14$107.15RVU24A
2023-10-01$313.99$109.58RVU23D
2023-07-01$313.99$109.58RVU23C
2023-04-01$313.99$109.58RVU23B
2023-01-01$313.99$109.58RVU23A
2022-10-01$324.81$112.29RVU22D
2022-07-01$324.81$112.29RVU22C
2022-04-01$324.81$112.29RVU22B
2022-01-01$324.81$112.29RVU22A
2021-10-01$320.12$111.45RVU21D
2021-07-01$320.12$111.45RVU21C
2021-04-01$320.12$111.45RVU21B
2021-01-01$320.12$111.45RVU21A
2020-10-01$294.11$113.52RVU20D
2020-07-01$294.11$113.52RVU20C
2020-04-01$294.11$113.52RVU20B
2020-01-01$294.11$113.52RVU20A
2019-10-01$282.23$111.61RVU19D
2019-07-01$282.23$111.61RVU19C
2019-04-01$282.23$111.61RVU19B
2019-01-01$282.23$111.61RVU19A
2018-10-01$273.38$111.81RVU18D
2018-07-01$273.38$111.81RVU18C
2018-04-01$273.38$111.81RVU18B
2018-01-01$273.38$111.81RVU18AR1
2017-10-01$268.98$111.96RVU17D
2017-07-01$268.98$111.96RVU17C
2017-04-01$268.98$111.96RVU17B
2017-01-01$268.98$111.96RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 45332 for an earlier date of service

Where the Salinas, CA rate applies

Salinas, CA is a Medicare payment area, not a city. Our Census mapping connects it to 30 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Salinas
  • 45332 in Aromas · multiple payment areas
  • Boronda
  • Bradley
  • Carmel Valley Village
  • Carmel-by-the-Sea
  • Castroville
  • Chualar

Browse all communities in California

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 Salinas, CAGPCI2026.csv, line 22 (RVU26D)

Open CMS sourceHow we calculate rates

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