CPT code 45334: Flexible sigmoidoscopy, endoscopic bleeding control2026 Medicare rate & RVUs in Washington, DC area
Reports flexible endoscopic examination of the rectum and distal colon when the endoscopist actively treats a bleeding site during the procedure.
In Washington, DC area, Medicare pays $632.40 for 45334 in the office and $116.17 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Washington, DC area 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. Washington, DC area pays $632.40. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$632.40
- Los Angeles, CA · California$630.61−$1.79
- Miami, FL · Florida$574.67−$57.73
- Chicago, IL · Illinois$556.43−$75.97
- Manhattan, NY · New York$628.98−$3.42
- Alaska · Alaska$604.02−$28.38
- Alabama · Alabama$481.96−$150.44
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $587.07 | $106.79 |
| Merced, CACalifornia | $587.07 | $106.79 |
| Modesto, CACalifornia | $587.07 | $106.79 |
| Napa, CACalifornia | $694.56 | $116.99 |
| Oxnard, CACalifornia | $628.99 | $111.01 |
| Redding, CACalifornia | $587.07 | $106.79 |
| Rest of CaliforniaCalifornia | $587.07 | $106.79 |
| Riverside, CACalifornia | $589.47 | $109.18 |
| Sacramento, CACalifornia | $619.91 | $110.26 |
| Salinas, CACalifornia | $617.70 | $109.80 |
| San Diego, CACalifornia | $635.13 | $111.02 |
| Marin County, CACalifornia | $739.68 | $121.79 |
| San Francisco, CACalifornia | $739.43 | $121.54 |
| San Benito County, CACalifornia | $756.31 | $124.40 |
| Santa Clara County, CACalifornia | $755.29 | $123.38 |
| San Luis Obispo, CACalifornia | $607.35 | $108.22 |
| Santa Cruz, CACalifornia | $643.46 | $111.02 |
| Santa Maria, CACalifornia | $620.80 | $109.84 |
| Santa Rosa, CACalifornia | $650.17 | $112.04 |
| Stockton, CACalifornia | $587.07 | $106.79 |
| Vallejo, CACalifornia | $694.20 | $116.63 |
| Visalia, CACalifornia | $587.07 | $106.79 |
| Yuba City, CACalifornia | $587.07 | $106.79 |
| ColoradoColorado | $573.46 | $107.19 |
| ConnecticutConnecticut | $583.26 | $111.30 |
| DelawareDelaware | $538.02 | $105.06 |
| Fort Lauderdale, FLFlorida | $556.17 | $112.25 |
| Rest of FloridaFlorida | $527.05 | $108.11 |
| Atlanta, GAGeorgia | $553.32 | $108.09 |
| Rest of GeorgiaGeorgia | $494.58 | $103.68 |
| Hawaii, Guam, HIHawaii | $605.62 | $107.36 |
| IowaIowa | $499.58 | $98.61 |
| IdahoIdaho | $502.50 | $99.34 |
| East St. Louis, ILIllinois | $513.82 | $110.66 |
| Rest of IllinoisIllinois | $507.21 | $107.11 |
| Suburban Chicago, ILIllinois | $562.96 | $112.91 |
| IndianaIndiana | $505.90 | $99.67 |
| KansasKansas | $495.18 | $99.03 |
| KentuckyKentucky | $491.13 | $101.55 |
| New Orleans, LALouisiana | $517.27 | $104.91 |
| Rest of LouisianaLouisiana | $489.56 | $101.73 |
| Metropolitan Boston, MAMassachusetts | $637.46 | $114.22 |
| Rest of MassachusettsMassachusetts | $568.65 | $107.20 |
| Baltimore area, MDMaryland | $581.31 | $111.10 |
| Rest of MarylandMaryland | $549.81 | $106.33 |
| Rest of MaineMaine | $503.59 | $100.43 |
| Southern Maine, MEMaine | $537.14 | $102.87 |
| Detroit, MIMichigan | $532.63 | $109.75 |
| Rest of MichiganMichigan | $504.02 | $103.92 |
| MinnesotaMinnesota | $552.60 | $101.68 |
| Metropolitan Kansas City, MOMissouri | $515.16 | $103.67 |
| Metropolitan St. Louis, MOMissouri | $521.48 | $104.29 |
| Rest of MissouriMissouri | $478.83 | $101.08 |
| MississippiMississippi | $476.63 | $99.32 |
| MontanaMontana | $544.09 | $105.87 |
| North CarolinaNorth Carolina | $509.85 | $100.99 |
| North DakotaNorth Dakota | $539.74 | $101.52 |
| NebraskaNebraska | $503.22 | $98.74 |
| New HampshireNew Hampshire | $562.52 | $106.33 |
| Northern New JerseyNew Jersey | $624.16 | $115.83 |
| Rest of New JerseyNew Jersey | $590.81 | $112.27 |
| New MexicoNew Mexico | $506.43 | $104.59 |
| NevadaNevada | $543.35 | $104.69 |
| NYC suburbs and Long Island, NYNew York | $643.70 | $122.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $593.38 | $113.53 |
| Queens, NYNew York | $637.35 | $119.38 |
| Rest of New YorkNew York | $518.34 | $102.03 |
| OhioOhio | $503.13 | $103.03 |
| OklahomaOklahoma | $492.00 | $100.67 |
| Portland, OROregon | $595.61 | $108.75 |
| Rest of OregonOregon | $540.03 | $103.56 |
| Metropolitan Philadelphia, PAPennsylvania | $566.03 | $109.84 |
| Rest of PennsylvaniaPennsylvania | $505.02 | $102.74 |
| Puerto RicoPuerto Rico | $549.18 | $106.14 |
| Rhode IslandRhode Island | $560.11 | $107.43 |
| South CarolinaSouth Carolina | $507.16 | $102.24 |
| South DakotaSouth Dakota | $539.22 | $101.00 |
| TennesseeTennessee | $497.78 | $99.44 |
| Austin, TXTexas | $570.75 | $107.11 |
| Beaumont, TXTexas | $501.13 | $102.35 |
| Brazoria, TXTexas | $538.76 | $104.48 |
| Dallas, TXTexas | $541.76 | $105.29 |
| Fort Worth, TXTexas | $537.14 | $105.05 |
| Galveston, TXTexas | $540.06 | $104.90 |
| Houston, TXTexas | $544.08 | $108.93 |
| Rest of TexasTexas | $519.34 | $103.46 |
| UtahUtah | $515.05 | $103.13 |
| VirginiaVirginia | $533.92 | $103.15 |
| Virgin Islands, VIUnited States Virgin Islands | $549.18 | $106.14 |
| VermontVermont | $535.75 | $101.92 |
| Rest of WashingtonWashington | $568.19 | $106.74 |
| King County, WAWashington | $653.07 | $115.37 |
| WisconsinWisconsin | $519.21 | $99.39 |
| West VirginiaWest Virginia | $485.49 | $104.67 |
| WyomingWyoming | $542.19 | $103.97 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $604.02 | 1 |
| AL | $481.96 | 1 |
| AR | $474.04 | 1 |
| AZ | $528.42 | 1 |
| CA | $587.07–$756.31 | 29 |
| CO | $573.46 | 1 |
| CT | $583.26 | 1 |
| DC | $632.40 | 1 |
| DE | $538.02 | 1 |
| FL | $527.05–$574.67 | 3 |
| GA | $494.58–$553.32 | 2 |
| GU | $605.62 | 1 |
| HI | $605.62 | 1 |
| IA | $499.58 | 1 |
| ID | $502.50 | 1 |
| IL | $507.21–$562.96 | 4 |
| IN | $505.90 | 1 |
| KS | $495.18 | 1 |
| KY | $491.13 | 1 |
| LA | $489.56–$517.27 | 2 |
| MA | $568.65–$637.46 | 2 |
| MD | $549.81–$632.40 | 3 |
| ME | $503.59–$537.14 | 2 |
| MI | $504.02–$532.63 | 2 |
| MN | $552.60 | 1 |
| MO | $478.83–$521.48 | 3 |
| MS | $476.63 | 1 |
| MT | $544.09 | 1 |
| NC | $509.85 | 1 |
| ND | $539.74 | 1 |
| NE | $503.22 | 1 |
| NH | $562.52 | 1 |
| NJ | $590.81–$624.16 | 2 |
| NM | $506.43 | 1 |
| NV | $543.35 | 1 |
| NY | $518.34–$643.70 | 5 |
| OH | $503.13 | 1 |
| OK | $492.00 | 1 |
| OR | $540.03–$595.61 | 2 |
| PA | $505.02–$566.03 | 2 |
| PR | $549.18 | 1 |
| RI | $560.11 | 1 |
| SC | $507.16 | 1 |
| SD | $539.22 | 1 |
| TN | $497.78 | 1 |
| TX | $501.13–$570.75 | 8 |
| UT | $515.05 | 1 |
| VA | $533.92–$632.40 | 2 |
| VI | $549.18 | 1 |
| VT | $535.75 | 1 |
| WA | $568.19–$653.07 | 2 |
| WI | $519.21 | 1 |
| WV | $485.49 | 1 |
| WY | $542.19 | 1 |
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
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 Washington, DC area 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
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.95 | × 1.054 | 2.0553 |
| Practice expense | 14.12 | × 1.178 | 16.6334 |
| Malpractice | 0.22 | × 1.113 | 0.2449 |
| Total RVUs | 18.9335 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$632.40
Office: (1.95 × 1.054 + 14.12 × 1.178 + 0.22 × 1.113) × $33.4009 = $632.40
Facility: (1.95 × 1.054 + 1 × 1.178 + 0.22 × 1.113) × $33.4009 = $116.17
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
| 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
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%).
How 45334 has changed in Washington, DC area
45334 · Office / nonfacility
$632.40
Effective 2026-10-01
The base rate is $92.65 higher than on 2025-10-01, moving from $539.75 to $632.40 (17.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$539.75changed to$632.40
- 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 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$573.30changed to$539.75
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 12.44 changed to 11.99
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$563.95changed to$573.30
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$601.58changed to$563.95
- 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 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$645.29changed to$601.58
- 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 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$679.95changed to$645.29
- 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.
January 1, 2021
RVU21A
$650.35changed to$679.95
- 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 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$656.49changed to$650.35
- 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
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$671.80changed to$656.49
- 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.
January 1, 2018
RVU18AR1
$664.85changed to$671.80
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 13.36 changed to 13.48
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$735.14changed to$664.85
- 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
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$735.14
Held through RVU16B, RVU16C, RVU16D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $632.40 | $116.17 | RVU26D |
| 2026-07-01 | $632.40 | $116.17 | RVU26C |
| 2026-04-01 | $632.40 | $116.17 | RVU26B |
| 2026-01-01 | $632.40 | $116.17 | RVU26A |
| 2025-10-01 | $539.75 | $125.64 | RVU25D |
| 2025-07-01 | $539.75 | $125.64 | RVU25C |
| 2025-04-01 | $539.75 | $125.64 | RVU25B |
| 2025-01-01 | $539.75 | $125.64 | RVU25A |
| 2024-10-01 | $573.30 | $128.90 | RVU24D |
| 2024-07-01 | $573.30 | $128.90 | RVU24C |
| 2024-04-01 | $573.30 | $128.90 | RVU24B |
| 2024-03-09 | $573.30 | $128.90 | RVU24AR |
| 2024-01-01 | $563.95 | $126.80 | RVU24A |
| 2023-10-01 | $601.58 | $131.78 | RVU23D |
| 2023-07-01 | $601.58 | $131.78 | RVU23C |
| 2023-04-01 | $601.58 | $131.78 | RVU23B |
| 2023-01-01 | $601.58 | $131.78 | RVU23A |
| 2022-10-01 | $645.29 | $135.01 | RVU22D |
| 2022-07-01 | $645.29 | $135.01 | RVU22C |
| 2022-04-01 | $645.29 | $135.01 | RVU22B |
| 2022-01-01 | $645.29 | $135.01 | RVU22A |
| 2021-10-01 | $679.95 | $134.81 | RVU21D |
| 2021-07-01 | $679.95 | $134.81 | RVU21C |
| 2021-04-01 | $679.95 | $134.81 | RVU21B |
| 2021-01-01 | $679.95 | $134.81 | RVU21A |
| 2020-10-01 | $650.35 | $136.99 | RVU20D |
| 2020-07-01 | $650.35 | $136.99 | RVU20C |
| 2020-04-01 | $650.35 | $136.99 | RVU20B |
| 2020-01-01 | $650.35 | $136.99 | RVU20A |
| 2019-10-01 | $656.49 | $138.40 | RVU19D |
| 2019-07-01 | $656.49 | $138.40 | RVU19C |
| 2019-04-01 | $656.49 | $138.40 | RVU19B |
| 2019-01-01 | $656.49 | $138.40 | RVU19A |
| 2018-10-01 | $671.80 | $138.66 | RVU18D |
| 2018-07-01 | $671.80 | $138.66 | RVU18C |
| 2018-04-01 | $671.80 | $138.66 | RVU18B |
| 2018-01-01 | $671.80 | $138.66 | RVU18AR1 |
| 2017-10-01 | $664.85 | $138.98 | RVU17D |
| 2017-07-01 | $664.85 | $138.98 | RVU17C |
| 2017-04-01 | $664.85 | $138.98 | RVU17B |
| 2017-01-01 | $664.85 | $138.98 | RVU17A |
| 2016-10-01 | $735.14 | $144.92 | RVU16D |
| 2016-07-01 | $735.14 | $144.92 | RVU16C |
| 2016-04-01 | $735.14 | $144.92 | RVU16B |
| 2016-01-01 | $735.14 | $144.92 | RVU16A |
| 2015-10-01 | Not available in this setting | $188.61 | RVU15D |
| 2015-07-01 | Not available in this setting | $188.61 | RVU15C |
| 2015-04-01 | Not available in this setting | $187.68 | RVU15B |
| 2015-01-01 | Not available in this setting | $187.68 | RVU15A |
| 2014-10-01 | Not available in this setting | $185.83 | RVU14D |
| 2014-07-01 | Not available in this setting | $185.83 | RVU14C |
| 2014-04-01 | Not available in this setting | $185.83 | RVU14B |
| 2014-01-01 | Not available in this setting | $185.83 | RVU14A |
| 2013-10-01 | Not available in this setting | $184.57 | RVU13D |
| 2013-07-01 | Not available in this setting | $184.57 | RVU13C |
| 2013-04-01 | Not available in this setting | $184.57 | RVU13B |
| 2013-01-01 | Not available in this setting | $184.57 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
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
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