CPT code 45342: Sigmoidoscopy, ultrasound-guided tissue sampling2026 Medicare rate & RVUs in Colorado
Reports flexible sigmoidoscopy with endoscopic ultrasound-guided needle sampling of a distal intestinal lesion or nearby target for tissue diagnosis.
In Colorado, Medicare pays $152.89 for 45342 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 45342 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 45342 covers
This procedure combines flexible examination of the rectum and sigmoid colon with endoscopic ultrasound imaging and needle aspiration or biopsy of a target. Gastroenterologists commonly use it to sample a subepithelial rectal or sigmoid lesion, or a nearby structure, when routine mucosal forceps biopsy may not reach the target. It is typically performed in an endoscopy suite, hospital outpatient department, or ambulatory surgery center.
Report 45342 when the endoscopic ultrasound is used to guide needle tissue sampling; documentation should identify the target and show that ultrasound guidance and sampling were performed. A standard mucosal biopsy without ultrasound-guided needle sampling is a different service. 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 for this service. 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.
How Colorado compares for 45342
Across 109 of 109 payment localities, the facility rate for 45342 runs from $139.83 in Arkansas to $197.60 in Alaska. Colorado pays $152.89. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Colorado · this page$152.89
- Los Angeles, CA · California$159.35+$6.46
- Washington, DC area · District of Columbia$165.80+$12.91
- Miami, FL · Florida$171.76+$18.87
- Chicago, IL · Illinois$168.10+$15.21
- Manhattan, NY · New York$171.78+$18.89
- Alaska · Alaska$197.60+$44.71
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $141.12 |
| ArkansasArkansas | — | $139.83 |
| ArizonaArizona | — | $148.59 |
| Bakersfield, CACalifornia | — | $152.86 |
| Chico, CACalifornia | — | $151.79 |
| El Centro, CACalifornia | — | $151.85 |
| Fresno, CACalifornia | — | $151.79 |
| Hanford, CACalifornia | — | $151.79 |
| Madera, CACalifornia | — | $151.79 |
| Merced, CACalifornia | — | $151.79 |
| Modesto, CACalifornia | — | $151.79 |
| Napa, CACalifornia | — | $165.34 |
| Oxnard, CACalifornia | — | $157.55 |
| Redding, CACalifornia | — | $151.79 |
| Rest of CaliforniaCalifornia | — | $151.79 |
| Riverside, CACalifornia | — | $155.69 |
| Sacramento, CACalifornia | — | $156.47 |
| Salinas, CACalifornia | — | $155.82 |
| San Diego, CACalifornia | — | $157.36 |
| Marin County, CACalifornia | — | $171.76 |
| San Francisco, CACalifornia | — | $171.35 |
| San Benito County, CACalifornia | — | $175.50 |
| Santa Clara County, CACalifornia | — | $173.83 |
| San Luis Obispo, CACalifornia | — | $153.61 |
| Santa Cruz, CACalifornia | — | $157.22 |
| Santa Maria, CACalifornia | — | $155.82 |
| Santa Rosa, CACalifornia | — | $158.65 |
| Stockton, CACalifornia | — | $151.79 |
| Vallejo, CACalifornia | — | $164.75 |
| Visalia, CACalifornia | — | $151.79 |
| Yuba City, CACalifornia | — | $151.79 |
| ConnecticutConnecticut | — | $159.38 |
| DelawareDelaware | — | $150.40 |
| Fort Lauderdale, FLFlorida | — | $161.91 |
| Rest of FloridaFlorida | — | $155.82 |
| Atlanta, GAGeorgia | — | $155.03 |
| Rest of GeorgiaGeorgia | — | $149.37 |
| Hawaii, Guam, HIHawaii | — | $152.39 |
| IowaIowa | — | $140.78 |
| IdahoIdaho | — | $141.91 |
| East St. Louis, ILIllinois | — | $160.44 |
| Rest of IllinoisIllinois | — | $154.72 |
| Suburban Chicago, ILIllinois | — | $162.75 |
| IndianaIndiana | — | $142.36 |
| KansasKansas | — | $141.60 |
| KentuckyKentucky | — | $145.91 |
| New Orleans, LALouisiana | — | $150.77 |
| Rest of LouisianaLouisiana | — | $146.26 |
| Metropolitan Boston, MAMassachusetts | — | $162.53 |
| Rest of MassachusettsMassachusetts | — | $153.00 |
| Baltimore area, MDMaryland | — | $159.14 |
| Rest of MarylandMaryland | — | $152.14 |
| Rest of MaineMaine | — | $143.70 |
| Southern Maine, MEMaine | — | $146.82 |
| Detroit, MIMichigan | — | $158.40 |
| Rest of MichiganMichigan | — | $149.50 |
| MinnesotaMinnesota | — | $144.41 |
| Metropolitan Kansas City, MOMissouri | — | $148.78 |
| Metropolitan St. Louis, MOMissouri | — | $149.63 |
| Rest of MissouriMissouri | — | $145.47 |
| MississippiMississippi | — | $142.61 |
| MontanaMontana | — | $151.62 |
| North CarolinaNorth Carolina | — | $144.46 |
| North DakotaNorth Dakota | — | $144.50 |
| NebraskaNebraska | — | $140.89 |
| New HampshireNew Hampshire | — | $151.88 |
| Northern New JerseyNew Jersey | — | $165.37 |
| Rest of New JerseyNew Jersey | — | $160.60 |
| New MexicoNew Mexico | — | $150.54 |
| NevadaNevada | — | $149.67 |
| NYC suburbs and Long Island, NYNew York | — | $176.18 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $162.57 |
| Queens, NYNew York | — | $170.90 |
| Rest of New YorkNew York | — | $145.95 |
| OhioOhio | — | $148.05 |
| OklahomaOklahoma | — | $144.42 |
| Portland, OROregon | — | $154.83 |
| Rest of OregonOregon | — | $147.90 |
| Metropolitan Philadelphia, PAPennsylvania | — | $157.45 |
| Rest of PennsylvaniaPennsylvania | — | $147.50 |
| Puerto RicoPuerto Rico | — | $151.93 |
| Rhode IslandRhode Island | — | $153.59 |
| South CarolinaSouth Carolina | — | $146.61 |
| South DakotaSouth Dakota | — | $143.66 |
| TennesseeTennessee | — | $142.21 |
| Austin, TXTexas | — | $152.92 |
| Beaumont, TXTexas | — | $146.97 |
| Brazoria, TXTexas | — | $149.39 |
| Dallas, TXTexas | — | $150.64 |
| Fort Worth, TXTexas | — | $150.37 |
| Galveston, TXTexas | — | $150.05 |
| Houston, TXTexas | — | $156.64 |
| Rest of TexasTexas | — | $148.31 |
| UtahUtah | — | $147.87 |
| VirginiaVirginia | — | $147.38 |
| Virgin Islands, VIUnited States Virgin Islands | — | $151.93 |
| VermontVermont | — | $145.28 |
| Rest of WashingtonWashington | — | $152.28 |
| King County, WAWashington | — | $163.93 |
| WisconsinWisconsin | — | $141.54 |
| West VirginiaWest Virginia | — | $151.27 |
| WyomingWyoming | — | $148.51 |
45342 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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 45342 rate is calculated
Each of 45342’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 · 45342
RVUs × geographic indexes × conversion factor
Work2.91
2.91 RVUs× 1.000 GPCI
Practice expense1.27
1.27 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
4.5400
Conversion factor
$33.4009
Medicare rate
$151.64
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
5,508
- Code
- 45342
- Physician work
- 2.91
- Practice expense
- 1.27
- Malpractice
- 0.36
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.91 | × 1.012 | 2.9449 |
| Practice expense | 1.27 | × 1.064 | 1.3513 |
| Malpractice | 0.36 | × 0.781 | 0.2812 |
| Total RVUs | 4.5774 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$152.89
Facility: (2.91 × 1.012 + 1.27 × 1.064 + 0.36 × 0.781) × $33.4009 = $152.89
Payment rules and modifiers for 45342
The CMS indicators that decide how 45342 is paid alongside other services.
CMS payment indicators · 45342
Sigmoidoscopy, ultrasound-guided tissue sampling
| 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
45342 without 51 · national facility
$151.64
Sigmoidoscopy, ultrasound-guided tissue sampling
45342-51 · Second procedure: 50%
$75.82
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 45342 has changed in Colorado
45342 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $152.89 | RVU26D |
| 2026-07-01 | Not available in this setting | $152.89 | RVU26C |
| 2026-04-01 | Not available in this setting | $152.89 | RVU26B |
| 2026-01-01 | Not available in this setting | $152.89 | RVU26A |
| 2025-10-01 | Not available in this setting | $164.48 | RVU25D |
| 2025-07-01 | Not available in this setting | $164.48 | RVU25C |
| 2025-04-01 | Not available in this setting | $164.48 | RVU25B |
| 2025-01-01 | Not available in this setting | $164.48 | RVU25A |
| 2024-10-01 | Not available in this setting | $169.19 | RVU24D |
| 2024-07-01 | Not available in this setting | $169.19 | RVU24C |
| 2024-04-01 | Not available in this setting | $169.19 | RVU24B |
| 2024-03-09 | Not available in this setting | $169.19 | RVU24AR |
| 2024-01-01 | Not available in this setting | $166.43 | RVU24A |
| 2023-10-01 | Not available in this setting | $170.65 | RVU23D |
| 2023-07-01 | Not available in this setting | $170.65 | RVU23C |
| 2023-04-01 | Not available in this setting | $170.65 | RVU23B |
| 2023-01-01 | Not available in this setting | $170.65 | RVU23A |
| 2022-10-01 | Not available in this setting | $171.77 | RVU22D |
| 2022-07-01 | Not available in this setting | $171.77 | RVU22C |
| 2022-04-01 | Not available in this setting | $171.77 | RVU22B |
| 2022-01-01 | Not available in this setting | $171.77 | RVU22A |
| 2021-10-01 | Not available in this setting | $172.56 | RVU21D |
| 2021-07-01 | Not available in this setting | $172.56 | RVU21C |
| 2021-04-01 | Not available in this setting | $172.56 | RVU21B |
| 2021-01-01 | Not available in this setting | $172.56 | RVU21A |
| 2020-10-01 | Not available in this setting | $177.27 | RVU20D |
| 2020-07-01 | Not available in this setting | $177.27 | RVU20C |
| 2020-04-01 | Not available in this setting | $177.27 | RVU20B |
| 2020-01-01 | Not available in this setting | $177.27 | RVU20A |
| 2019-10-01 | Not available in this setting | $180.36 | RVU19D |
| 2019-07-01 | Not available in this setting | $180.36 | RVU19C |
| 2019-04-01 | Not available in this setting | $180.36 | RVU19B |
| 2019-01-01 | Not available in this setting | $180.36 | RVU19A |
| 2018-10-01 | Not available in this setting | $181.26 | RVU18D |
| 2018-07-01 | Not available in this setting | $181.26 | RVU18C |
| 2018-04-01 | Not available in this setting | $181.26 | RVU18B |
| 2018-01-01 | Not available in this setting | $181.26 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $180.86 | RVU17D |
| 2017-07-01 | Not available in this setting | $180.86 | RVU17C |
| 2017-04-01 | Not available in this setting | $180.86 | RVU17B |
| 2017-01-01 | Not available in this setting | $180.86 | RVU17A |
| 2016-10-01 | Not available in this setting | $185.95 | RVU16D |
| 2016-07-01 | Not available in this setting | $185.95 | RVU16C |
| 2016-04-01 | Not available in this setting | $185.95 | RVU16B |
| 2016-01-01 | Not available in this setting | $185.95 | RVU16A |
| 2015-10-01 | Not available in this setting | $245.91 | RVU15D |
| 2015-07-01 | Not available in this setting | $245.91 | RVU15C |
| 2015-04-01 | Not available in this setting | $244.68 | RVU15B |
| 2015-01-01 | Not available in this setting | $244.68 | RVU15A |
| 2014-10-01 | Not available in this setting | $243.83 | RVU14D |
| 2014-07-01 | Not available in this setting | $243.83 | RVU14C |
| 2014-04-01 | Not available in this setting | $243.83 | RVU14B |
| 2014-01-01 | Not available in this setting | $243.83 | RVU14A |
| 2013-10-01 | Not available in this setting | $240.31 | RVU13D |
| 2013-07-01 | Not available in this setting | $240.31 | RVU13C |
| 2013-04-01 | Not available in this setting | $240.31 | RVU13B |
| 2013-01-01 | Not available in this setting | $240.31 | RVU13AR |
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
45342 billing questions
How does 45342 differ from 45341?
45342 includes endoscopic ultrasound-guided needle aspiration or biopsy. Use 45341 when ultrasound examination is performed without guided needle sampling.
Can a routine mucosal biopsy support 45342?
No. 45342 describes ultrasound-guided needle sampling; a routine forceps biopsy of the mucosal lining is a different service.
Should the diagnostic sigmoidoscopy be billed separately?
The code includes the sigmoidoscopic examination needed to perform the ultrasound-guided sampling. Do not separately report a diagnostic examination for that same service.
What documentation supports reporting 45342?
Document the lesion or target, the endoscopic ultrasound findings, and the needle aspiration or biopsy performed under ultrasound guidance.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for 45342.
What happens when related endoscopies are performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The service has a 0-day global period, so same-day preoperative and postoperative care is included.
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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