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CPT code 45340: Sigmoidoscopy dilation, transendoscopic balloon2026 Medicare rate & RVUs in Montana

Reports flexible sigmoidoscopy in which an endoscopist passes and inflates a balloon through the scope to widen a rectal or sigmoid stricture.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In Montana, Medicare pays $507.35 for 45340 in the office and $72.47 when it’s performed in a hospital or facility.

$507.35Office (non-facility)
$72.47Hospital or facility
−0.0%vs the national office rate ($507.36)

Check a contract rate as a % of Medicare · 45340 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 45340 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 45340 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 45340 covers

During flexible sigmoidoscopy, the endoscopist guides a dilation balloon through the scope to a narrowed area in the rectum or sigmoid colon, then inflates it under endoscopic visualization to enlarge the passage. Gastroenterologists and colorectal surgeons commonly perform this treatment for a stricture that limits passage through the distal bowel, including a narrowing at a surgical anastomosis. The procedure may take place in an endoscopy unit or hospital outpatient setting.

Report 45340 when the flexible sigmoidoscopy includes transendoscopic balloon dilation; diagnostic inspection alone is not the dilation service. The procedure note should identify the narrowed site and document balloon dilation. 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. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgery 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 Montana compares for 45340

Across 109 of 109 payment localities, the office rate for 45340 runs from $439.61 in Arkansas to $712.94 in San Benito County, CA. Montana pays $507.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

45340 in Montana vs other payment areas
  1. Montana · this page$507.35
  2. Los Angeles, CA · California$591.47+$84.12
  3. Washington, DC area · District of Columbia$592.25+$84.90
  4. Miami, FL · Florida$534.94+$27.59
  5. Chicago, IL · Illinois$517.30+$9.95
  6. Manhattan, NY · New York$587.97+$80.62
  7. Alaska · Alaska$555.15+$47.80

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

Every other payment area

45340 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$447.28$66.76
ArkansasArkansas$439.61$66.05
ArizonaArizona$492.25$70.85
Bakersfield, CACalifornia$550.16$73.54
Chico, CACalifornia$549.67$73.04
El Centro, CACalifornia$549.70$73.07
Fresno, CACalifornia$549.67$73.04
Hanford, CACalifornia$549.67$73.04

45340 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.

$439.61

$631.31

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

View every state and territory as a table
45340 office rate range by state
State / territoryOffice rate rangeLocalities
AK$555.151
AL$447.281
AR$439.611
AZ$492.251
CA$549.67–$712.9429
CO$536.101
CT$544.861
DC$592.251
DE$501.461
FL$489.93–$534.943
GA$458.67–$516.002
GU$568.121
HI$568.121
IA$464.761
ID$467.491
IL$470.46–$524.474
IN$470.791
KS$460.291
KY$455.711
LA$454.11–$480.942
MA$531.29–$597.832
MD$512.83–$592.253
ME$468.34–$501.122
MI$467.99–$495.122
MN$516.731
MO$443.60–$485.253
MS$441.811
MT$507.351
NC$474.431
ND$503.991
NE$468.341
NH$525.551
NJ$551.95–$584.062
NM$470.241
NV$506.871
NY$482.63–$601.955
OH$467.301
OK$456.771
OR$503.83–$557.722
PA$469.25–$528.092
PR$512.341
RI$522.731
SC$471.481
SD$503.591
TN$462.791
TX$465.47–$533.538
UT$479.121
VA$497.85–$592.252
VI$512.341
VT$499.951
WA$530.96–$612.992
WI$484.071
WV$449.421
WY$505.881

See 45340 in every payment locality

How the 45340 rate is calculated

Each of 45340’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 · 45340

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.22

1.22 RVUs× 1.000 GPCI

Practice expense13.80

13.80 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

15.1900

Conversion factor

$33.4009

Medicare rate

$507.36

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

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,506

Code
45340
Physician work
1.22
Practice expense
13.80
Malpractice
0.17

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 45340 in Montana
ComponentRVULocality factorAdjusted
Physician work1.22× 1.0001.2200
Practice expense13.80× 1.00013.8000
Malpractice0.17× 0.9980.1697
Total RVUs15.1897
Conversion factor× 33.4009

Office rate, Montana$507.35

Office: (1.22 × 1 + 13.8 × 1 + 0.17 × 0.998) × $33.4009 = $507.35

Facility: (1.22 × 1 + 0.78 × 1 + 0.17 × 0.998) × $33.4009 = $72.47

Open 45340 in the RVU calculator

Payment rules and modifiers for 45340

The CMS indicators that decide how 45340 is paid alongside other services.

CMS payment indicators · 45340

Sigmoidoscopy dilation, transendoscopic balloon

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

45340 without 51 · national office

$507.36

Sigmoidoscopy dilation, transendoscopic balloon

45340-51 · Second procedure: 50%

$253.68

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 45340

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

Codes related to 45340
CodeHow it relatesOffice range, Montana
Same family
45386Colonoscopy, balloon dilationColonoscopic counterpart for transendoscopic balloon dilation when the examination is a colonoscopy.$670.33
Used instead
45303Proctosigmoidoscopy, dilation of a narrowingDilation performed with proctosigmoidoscopy rather than flexible sigmoidoscopy.$1,025.39
45330Flexible sigmoidoscopy, diagnosticDiagnostic flexible sigmoidoscopy without balloon dilation.$215.09
Often billed with
45331Sigmoidoscopy, with biopsyMay describe biopsy during a separately documented sigmoidoscopy service; endoscopy family pricing applies when related endoscopies are performed together.$322.98

How 45340 has changed in Montana

45340 · Office / nonfacility

$507.35

Effective 2026-10-01

The base rate is $81.14 higher than on 2025-10-01, moving from $426.21 to $507.35 (19.0%).

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

    $426.21changed to$507.35

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.25 changed to 1.22
    • Practice expense RVU 11.77 changed to 13.80
    • Malpractice RVU 0.16 changed to 0.17
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $452.91changed to$426.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 12.18 changed to 11.77
    • Malpractice RVU 0.18 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $445.52changed to$452.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $468.19changed to$445.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.39 changed to 12.18

  5. January 1, 2023

    RVU23A

    $495.07changed to$468.19

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.88 changed to 12.39
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $501.98changed to$495.07

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.98 changed to 12.88
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $468.03changed to$501.98

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.51 changed to 12.98
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $458.91changed to$468.03

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.19 changed to 11.51
    • Malpractice RVU 0.18 changed to 0.16
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $448.55changed to$458.91

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.90 changed to 11.19
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $441.69changed to$448.55

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.80 changed to 10.90
    • Malpractice RVU 0.18 changed to 0.19
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $499.30changed to$441.69

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.35 changed to 1.25
    • Practice expense RVU 12.35 changed to 10.80
    • Malpractice RVU 0.20 changed to 0.18
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $500.47changed to$499.30

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 1.89 changed to 1.35
    • Practice expense RVU 11.67 changed to 12.35
    • Malpractice RVU 0.30 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $497.98changed to$500.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $495.71changed to$497.98

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.61 changed to 11.67
    • Malpractice RVU 0.29 changed to 0.30
    • Malpractice GPCI 1.165 changed to 1.226

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $531.13changed to$495.71

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.39 changed to 11.61
    • Malpractice RVU 0.30 changed to 0.29
    • Malpractice GPCI 1.103 changed to 1.165

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $531.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$507.35$72.47RVU26D
2026-07-01$507.35$72.47RVU26C
2026-04-01$507.35$72.47RVU26B
2026-01-01$507.35$72.47RVU26A
2025-10-01$426.21$74.93RVU25D
2025-07-01$426.21$74.93RVU25C
2025-04-01$426.21$74.93RVU25B
2025-01-01$426.21$74.93RVU25A
2024-10-01$452.91$77.43RVU24D
2024-07-01$452.91$77.43RVU24C
2024-04-01$452.91$77.43RVU24B
2024-03-09$452.91$77.43RVU24AR
2024-01-01$445.52$76.16RVU24A
2023-10-01$468.19$78.15RVU23D
2023-07-01$468.19$78.15RVU23C
2023-04-01$468.19$78.15RVU23B
2023-01-01$468.19$78.15RVU23A
2022-10-01$495.07$79.10RVU22D
2022-07-01$495.07$79.10RVU22C
2022-04-01$495.07$79.10RVU22B
2022-01-01$495.07$79.10RVU22A
2021-10-01$501.98$78.73RVU21D
2021-07-01$501.98$78.73RVU21C
2021-04-01$501.98$78.73RVU21B
2021-01-01$501.98$78.73RVU21A
2020-10-01$468.03$82.60RVU20D
2020-07-01$468.03$82.60RVU20C
2020-04-01$468.03$82.60RVU20B
2020-01-01$468.03$82.60RVU20A
2019-10-01$458.91$85.54RVU19D
2019-07-01$458.91$85.54RVU19C
2019-04-01$458.91$85.54RVU19B
2019-01-01$458.91$85.54RVU19A
2018-10-01$448.55$86.40RVU18D
2018-07-01$448.55$86.40RVU18C
2018-04-01$448.55$86.40RVU18B
2018-01-01$448.55$86.40RVU18AR1
2017-10-01$441.69$84.60RVU17D
2017-07-01$441.69$84.60RVU17C
2017-04-01$441.69$84.60RVU17B
2017-01-01$441.69$84.60RVU17A
2016-10-01$499.30$88.62RVU16D
2016-07-01$499.30$88.62RVU16C
2016-04-01$499.30$88.62RVU16B
2016-01-01$499.30$88.62RVU16A
2015-10-01$500.47$122.09RVU15D
2015-07-01$500.47$122.09RVU15C
2015-04-01$497.98$121.49RVU15B
2015-01-01$497.98$121.49RVU15A
2014-10-01$495.71$120.65RVU14D
2014-07-01$495.71$120.65RVU14C
2014-04-01$495.71$120.65RVU14B
2014-01-01$495.71$120.65RVU14A
2013-10-01$531.13$119.79RVU13D
2013-07-01$531.13$119.79RVU13C
2013-04-01$531.13$119.79RVU13B
2013-01-01$531.13$119.79RVU13AR

Price 45340 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

45340 billing questions

When should 45340 be chosen over 45330?

Use 45340 when a balloon is passed through the flexible sigmoidoscope and inflated to widen a stricture. Use 45330 for diagnostic flexible sigmoidoscopy without that therapeutic dilation.

Can the diagnostic sigmoidoscopy be reported separately?

Inspection of the bowel as part of the dilation procedure is integral to reporting 45340. Do not separately report a diagnostic examination for that same scope passage.

What documentation supports 45340?

Document the stricture's location and the transendoscopic balloon dilation performed. The record should make clear that dilation, rather than inspection alone, was carried out.

Should modifier 50 be appended for a stricture on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the sigmoidoscopy dilation without modifier 50.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 45340. Co-surgeons and team surgery are not permitted for this code.

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 45340PPRRVU2026_Oct_nonQPP.csv, line 5,506 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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