CPT code 45334: Flexible sigmoidoscopy, endoscopic bleeding control2026 Medicare rate & RVUs in Colorado

Reports flexible endoscopic examination of the rectum and distal colon when the endoscopist actively treats a bleeding site during the procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality3.5K Medicare services in 2024

In Colorado, Medicare pays $573.46 for 45334 in the office and $107.19 when it’s performed in a hospital or facility.

$573.46Office (non-facility)
$107.19Hospital or facility
+5.4%vs the national office rate ($544.10)

Check a contract rate as a % of Medicare · 45334 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 45334 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 45334 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 45334 covers

A gastroenterologist or colorectal surgeon uses a flexible endoscope to examine the rectum and distal colon and treat a bleeding site, such as a bleeding lesion or a bleeding point seen during evaluation of hematochezia. Hemostasis may be achieved with an endoscopic technique such as injection, thermal treatment, or a clip. The code reflects treatment of bleeding, not visualization alone.

Report it when the procedure note supports endoscopic treatment intended to control bleeding, including the site and method used. A diagnostic examination performed as part of the same treatment session is not a separate service merely because the endoscopist first inspected the area. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. 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 Colorado compares for 45334

Across 109 of 109 payment localities, the office rate for 45334 runs from $474.04 in Arkansas to $756.31 in San Benito County, CA. Colorado pays $573.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

45334 in Colorado vs other payment areas
  1. Colorado · this page$573.46
  2. Los Angeles, CA · California$630.61+$57.15
  3. Washington, DC area · District of Columbia$632.40+$58.94
  4. Miami, FL · Florida$574.67+$1.21
  5. Chicago, IL · Illinois$556.43−$17.03
  6. Manhattan, NY · New York$628.98+$55.52
  7. Alaska · Alaska$604.02+$30.56

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

Every other payment area

45334 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$481.96$98.52
ArkansasArkansas$474.04$97.61
ArizonaArizona$528.42$103.79
Bakersfield, CACalifornia$587.74$107.45
Chico, CACalifornia$587.07$106.79
El Centro, CACalifornia$587.11$106.82
Fresno, CACalifornia$587.07$106.79
Hanford, CACalifornia$587.07$106.79

45334 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.

$474.04

$671.69

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

View every state and territory as a table
45334 office rate range by state
State / territoryOffice rate rangeLocalities
AK$604.021
AL$481.961
AR$474.041
AZ$528.421
CA$587.07–$756.3129
CO$573.461
CT$583.261
DC$632.401
DE$538.021
FL$527.05–$574.673
GA$494.58–$553.322
GU$605.621
HI$605.621
IA$499.581
ID$502.501
IL$507.21–$562.964
IN$505.901
KS$495.181
KY$491.131
LA$489.56–$517.272
MA$568.65–$637.462
MD$549.81–$632.403
ME$503.59–$537.142
MI$504.02–$532.632
MN$552.601
MO$478.83–$521.483
MS$476.631
MT$544.091
NC$509.851
ND$539.741
NE$503.221
NH$562.521
NJ$590.81–$624.162
NM$506.431
NV$543.351
NY$518.34–$643.705
OH$503.131
OK$492.001
OR$540.03–$595.612
PA$505.02–$566.032
PR$549.181
RI$560.111
SC$507.161
SD$539.221
TN$497.781
TX$501.13–$570.758
UT$515.051
VA$533.92–$632.402
VI$549.181
VT$535.751
WA$568.19–$653.072
WI$519.211
WV$485.491
WY$542.191

See 45334 in every payment locality

How the 45334 rate is calculated

Each of 45334’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 · 45334

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.95

1.95 RVUs× 1.000 GPCI

Practice expense14.12

14.12 RVUs× 1.000 GPCI

Malpractice0.22

0.22 RVUs× 1.000 GPCI

Adjusted RVUs

16.2900

Conversion factor

$33.4009

Medicare rate

$544.10

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,502

Code
45334
Physician work
1.95
Practice expense
14.12
Malpractice
0.22

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Office calculation for 45334 in Colorado
ComponentRVULocality factorAdjusted
Physician work1.95× 1.0121.9734
Practice expense14.12× 1.06415.0237
Malpractice0.22× 0.7810.1718
Total RVUs17.1689
Conversion factor× 33.4009

Office rate, Colorado$573.46

Office: (1.95 × 1.012 + 14.12 × 1.064 + 0.22 × 0.781) × $33.4009 = $573.46

Facility: (1.95 × 1.012 + 1 × 1.064 + 0.22 × 0.781) × $33.4009 = $107.19

Open 45334 in the RVU calculator

Payment rules and modifiers for 45334

The CMS indicators that decide how 45334 is paid alongside other services.

CMS payment indicators · 45334

Flexible sigmoidoscopy, endoscopic bleeding control

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

45334 without 51 · national office

$544.10

Flexible sigmoidoscopy, endoscopic bleeding control

45334-51 · Second procedure: 50%

$272.05

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 45334 has changed in Colorado

45334 · Office / nonfacility

$573.46

Effective 2026-10-01

The base rate is $93.44 higher than on 2025-10-01, moving from $480.02 to $573.46 (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

    $480.02changed to$573.46

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.00 changed to 1.95
    • Practice expense RVU 11.99 changed to 14.12
    • Malpractice RVU 0.24 changed to 0.22
    • Work GPCI 1.008 changed to 1.012
    • Practice expense GPCI 1.053 changed to 1.064
    • Malpractice GPCI 0.827 changed to 0.781

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $509.76changed to$480.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 12.44 changed to 11.99

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $501.44changed to$509.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $524.26changed to$501.44

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.63 changed to 12.44
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.005 changed to 1.008
    • Practice expense GPCI 1.050 changed to 1.053
    • Malpractice GPCI 0.797 changed to 0.827
  5. January 1, 2023

    RVU23A

    $551.48changed to$524.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 13.14 changed to 12.63
    • Malpractice RVU 0.23 changed to 0.25
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.047 changed to 1.050
    • Malpractice GPCI 0.767 changed to 0.797

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $581.00changed to$551.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.83 changed to 13.14
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $556.88changed to$581.00

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.80 changed to 13.83
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $562.83changed to$556.88

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 13.10 changed to 12.80
    • Malpractice RVU 0.27 changed to 0.23
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $575.76changed to$562.83

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.48 changed to 13.10
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $568.39changed to$575.76

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.36 changed to 13.48
    • Practice expense GPCI 1.015 changed to 1.018
    • Malpractice GPCI 1.066 changed to 1.042

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $625.83changed to$568.39

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 2.10 changed to 2.00
    • Practice expense RVU 14.91 changed to 13.36
    • Malpractice RVU 0.28 changed to 0.26
    • Practice expense GPCI 1.011 changed to 1.015
    • Malpractice GPCI 1.090 changed to 1.066

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$625.83

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$573.46$107.19RVU26D
2026-07-01$573.46$107.19RVU26C
2026-04-01$573.46$107.19RVU26B
2026-01-01$573.46$107.19RVU26A
2025-10-01$480.02$114.21RVU25D
2025-07-01$480.02$114.21RVU25C
2025-04-01$480.02$114.21RVU25B
2025-01-01$480.02$114.21RVU25A
2024-10-01$509.76$117.18RVU24D
2024-07-01$509.76$117.18RVU24C
2024-04-01$509.76$117.18RVU24B
2024-03-09$509.76$117.18RVU24AR
2024-01-01$501.44$115.27RVU24A
2023-10-01$524.26$117.92RVU23D
2023-07-01$524.26$117.92RVU23C
2023-04-01$524.26$117.92RVU23B
2023-01-01$524.26$117.92RVU23A
2022-10-01$551.48$119.23RVU22D
2022-07-01$551.48$119.23RVU22C
2022-04-01$551.48$119.23RVU22B
2022-01-01$551.48$119.23RVU22A
2021-10-01$581.00$119.22RVU21D
2021-07-01$581.00$119.22RVU21C
2021-04-01$581.00$119.22RVU21B
2021-01-01$581.00$119.22RVU21A
2020-10-01$556.88$122.56RVU20D
2020-07-01$556.88$122.56RVU20C
2020-04-01$556.88$122.56RVU20B
2020-01-01$556.88$122.56RVU20A
2019-10-01$562.83$125.14RVU19D
2019-07-01$562.83$125.14RVU19C
2019-04-01$562.83$125.14RVU19B
2019-01-01$562.83$125.14RVU19A
2018-10-01$575.76$125.36RVU18D
2018-07-01$575.76$125.36RVU18C
2018-04-01$575.76$125.36RVU18B
2018-01-01$575.76$125.36RVU18AR1
2017-10-01$568.39$125.44RVU17D
2017-07-01$568.39$125.44RVU17C
2017-04-01$568.39$125.44RVU17B
2017-01-01$568.39$125.44RVU17A
2016-10-01$625.83$130.64RVU16D
2016-07-01$625.83$130.64RVU16C
2016-04-01$625.83$130.64RVU16B
2016-01-01$625.83$130.64RVU16A
2015-10-01Not available in this setting$170.08RVU15D
2015-07-01Not available in this setting$170.08RVU15C
2015-04-01Not available in this setting$169.23RVU15B
2015-01-01Not available in this setting$169.23RVU15A
2014-10-01Not available in this setting$167.13RVU14D
2014-07-01Not available in this setting$167.13RVU14C
2014-04-01Not available in this setting$167.13RVU14B
2014-01-01Not available in this setting$167.13RVU14A
2013-10-01Not available in this setting$164.91RVU13D
2013-07-01Not available in this setting$164.91RVU13C
2013-04-01Not available in this setting$164.91RVU13B
2013-01-01Not available in this setting$164.91RVU13AR

Price 45334 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

45334 billing questions

Can the diagnostic examination be billed separately when bleeding is treated?

The inspection that leads to treatment during the same session is part of the therapeutic service. Document the bleeding site and the treatment performed.

How does this differ from flexible sigmoidoscopy with biopsy?

Code 45331 describes a procedure that includes tissue sampling. This code describes endoscopic treatment directed at controlling bleeding.

How does this differ from the polypectomy code?

Code 45333 is for removal of a polyp by snare technique. Choose this code when the service performed is control of bleeding, rather than polyp removal.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this procedure. CMS does not permit co-surgeons or team surgery for it.

What documentation supports reporting this service?

The report should identify the bleeding site and describe the endoscopic technique used to control it. A note documenting only examination or a finding of blood does not establish that bleeding was treated.

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 45334PPRRVU2026_Oct_nonQPP.csv, line 5,502 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

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