CPT code 45341: Sigmoidoscopy ultrasound, endoscopic ultrasound examination2026 Medicare rate & RVUs in Massachusetts
Reports flexible sigmoidoscopy with endoscopic ultrasound to evaluate rectal or distal colonic wall layers and nearby structures.
CMS doesn’t publish an office rate for 45341 in Massachusetts.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 45341 covers
A flexible sigmoidoscope equipped for endoscopic ultrasound is advanced into the rectum or sigmoid colon. The ultrasound images help assess bowel-wall layers and nearby tissues, such as when evaluating a rectal lesion or local disease extent. Gastroenterologists and other physicians trained in endoscopic ultrasound typically perform the service in an outpatient endoscopy unit or hospital facility.
Report 45341 when the endoscopic ultrasound examination is performed; it does not describe ultrasound-guided needle sampling, which is represented by 45342. Document the scope extent, ultrasound findings, and clinical target. The code has 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, and 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.
Where 45341 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $120.29 |
| Rest of Massachusetts | Unavailable | $112.95 |
How the 45341 rate is calculated
Each of 45341’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 · 45341
RVUs × geographic indexes × conversion factor
Work2.07
2.07 RVUs× 1.000 GPCI
Practice expense1.04
1.04 RVUs× 1.000 GPCI
Malpractice0.23
0.23 RVUs× 1.000 GPCI
Adjusted RVUs
3.3400
Conversion factor
$33.4009
Medicare rate
$111.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45341
The CMS indicators that decide how 45341 is paid alongside other services.
CMS payment indicators · 45341
Sigmoidoscopy ultrasound, endoscopic ultrasound examination
| 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
45341 without 51 · national facility
$111.56
Sigmoidoscopy ultrasound, endoscopic ultrasound examination
45341-51 · Second procedure: 50%
$55.78
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%).
45341 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45342SigmoidoscopyUltrasound-guided tissue sampling
- 45341 covers the endoscopic ultrasound examination; 45342 is for ultrasound-guided fine-needle aspiration or biopsy.
- 45330Flexible sigmoidoscopyDiagnostic
- 45330 is diagnostic flexible sigmoidoscopy without endoscopic ultrasound. Choose 45341 when the ultrasound examination is performed.
- 45331SigmoidoscopyWith biopsy
- 45331 reports flexible sigmoidoscopy with biopsy. It does not represent an endoscopic ultrasound examination or ultrasound-guided sampling.
- 45378ColonoscopyDiagnostic, no tissue removal
- 45378 describes diagnostic colonoscopy, a more extensive colonic examination; it does not describe rectal or sigmoid endoscopic ultrasound.
45341 billing questions
How does 45341 differ from 45342?
45341 reports the endoscopic ultrasound examination. Use 45342 when the ultrasound guides fine-needle aspiration or biopsy.
Can I also report diagnostic sigmoidoscopy for the same session?
The sigmoidoscopy is part of 45341. Do not separately report a diagnostic sigmoidoscopy code for the same examination.
What documentation supports 45341?
Document the sigmoidoscope examination, the rectal or sigmoid ultrasound target, and the relevant ultrasound findings.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inapplicable to this code.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure.
How are related endoscopies priced when performed together?
CMS applies endoscopy family pricing when related endoscopies are performed together.
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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