CPT code 45350: Sigmoidoscopy, endoscopic band ligation2026 Medicare rate & RVUs in Washington, DC area
Reports flexible sigmoidoscopy used to place bands on target tissue, commonly internal hemorrhoids, during endoscopic treatment of the rectum or distal colon.
In Washington, DC area, Medicare pays $868.60 for 45350 in the office and $100.95 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 45350 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 45350 covers
A clinician advances a flexible sigmoidoscope to examine the rectum and distal colon, then applies bands to selected tissue. A common use is endoscopic treatment of internal hemorrhoids. Gastroenterologists and colorectal surgeons typically perform the procedure in an office-based endoscopy suite or hospital outpatient department. The scope examination and band placement are reported together as the therapeutic service.
Choose this code when the documented procedure includes endoscopic band ligation, rather than diagnostic inspection alone or treatment by a different method. The report should identify the indication, endoscopic findings, target tissue, and treatment performed. 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. CMS does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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 45350
Across 109 of 109 payment localities, the office rate for 45350 runs from $643.98 in Arkansas to $1,047.59 in San Benito County, CA. Washington, DC area pays $868.60. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$868.60
- Los Angeles, CA · California$868.15−$0.45
- Miami, FL · Florida$782.18−$86.42
- Chicago, IL · Illinois$756.38−$112.22
- Manhattan, NY · New York$861.56−$7.04
- Alaska · Alaska$812.05−$56.55
- Alabama · Alabama$655.25−$213.35
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $643.98 | $84.21 |
| ArizonaArizona | $721.36 | $89.91 |
| Bakersfield, CACalifornia | $807.25 | $93.04 |
| Chico, CACalifornia | $806.63 | $92.41 |
| El Centro, CACalifornia | $806.66 | $92.45 |
| Fresno, CACalifornia | $806.63 | $92.41 |
| Hanford, CACalifornia | $806.63 | $92.41 |
| Madera, CACalifornia | $806.63 | $92.41 |
| Merced, CACalifornia | $806.63 | $92.41 |
| Modesto, CACalifornia | $806.63 | $92.41 |
| Napa, CACalifornia | $960.29 | $101.41 |
| Oxnard, CACalifornia | $866.47 | $96.21 |
| Redding, CACalifornia | $806.63 | $92.41 |
| Rest of CaliforniaCalifornia | $806.63 | $92.41 |
| Riverside, CACalifornia | $808.90 | $94.69 |
| Sacramento, CACalifornia | $853.34 | $95.47 |
| Salinas, CACalifornia | $850.34 | $95.08 |
| San Diego, CACalifornia | $875.55 | $96.18 |
| Marin County, CACalifornia | $1,024.42 | $105.59 |
| San Francisco, CACalifornia | $1,024.18 | $105.35 |
| San Benito County, CACalifornia | $1,047.59 | $107.91 |
| Santa Clara County, CACalifornia | $1,046.62 | $106.94 |
| San Luis Obispo, CACalifornia | $835.94 | $93.71 |
| Santa Cruz, CACalifornia | $887.97 | $96.21 |
| Santa Maria, CACalifornia | $854.95 | $95.12 |
| Santa Rosa, CACalifornia | $897.32 | $97.10 |
| Stockton, CACalifornia | $806.63 | $92.41 |
| Vallejo, CACalifornia | $959.94 | $101.07 |
| Visalia, CACalifornia | $806.63 | $92.41 |
| Yuba City, CACalifornia | $806.63 | $92.41 |
| ColoradoColorado | $786.25 | $92.90 |
| ConnecticutConnecticut | $798.56 | $96.74 |
| DelawareDelaware | $734.89 | $91.06 |
| Fort Lauderdale, FLFlorida | $758.03 | $97.91 |
| Rest of FloridaFlorida | $717.04 | $94.06 |
| Atlanta, GAGeorgia | $755.99 | $93.91 |
| Rest of GeorgiaGeorgia | $671.23 | $89.95 |
| Hawaii, Guam, HIHawaii | $833.95 | $93.02 |
| IowaIowa | $681.33 | $85.07 |
| IdahoIdaho | $685.27 | $85.75 |
| East St. Louis, ILIllinois | $696.08 | $96.56 |
| Rest of IllinoisIllinois | $688.14 | $93.19 |
| Suburban Chicago, ILIllinois | $767.71 | $98.46 |
| IndianaIndiana | $690.13 | $86.05 |
| KansasKansas | $674.58 | $85.49 |
| KentuckyKentucky | $667.24 | $87.92 |
| New Orleans, LALouisiana | $704.24 | $91.03 |
| Rest of LouisianaLouisiana | $664.81 | $88.10 |
| Metropolitan Boston, MAMassachusetts | $877.23 | $99.16 |
| Rest of MassachusettsMassachusetts | $779.09 | $92.90 |
| Baltimore area, MDMaryland | $795.81 | $96.59 |
| Rest of MarylandMaryland | $751.66 | $92.19 |
| Rest of MaineMaine | $686.32 | $86.80 |
| Southern Maine, MEMaine | $734.78 | $88.99 |
| Detroit, MIMichigan | $724.46 | $95.61 |
| Rest of MichiganMichigan | $685.10 | $90.14 |
| MinnesotaMinnesota | $758.34 | $87.79 |
| Metropolitan Kansas City, MOMissouri | $701.76 | $89.86 |
| Metropolitan St. Louis, MOMissouri | $710.80 | $90.42 |
| Rest of MissouriMissouri | $649.25 | $87.52 |
| MississippiMississippi | $646.92 | $85.84 |
| MontanaMontana | $743.49 | $91.84 |
| North CarolinaNorth Carolina | $695.30 | $87.31 |
| North DakotaNorth Dakota | $739.34 | $87.69 |
| NebraskaNebraska | $686.65 | $85.17 |
| New HampshireNew Hampshire | $770.58 | $92.21 |
| Northern New JerseyNew Jersey | $856.51 | $100.59 |
| Rest of New JerseyNew Jersey | $809.09 | $97.49 |
| New MexicoNew Mexico | $688.33 | $90.77 |
| NevadaNevada | $743.01 | $90.71 |
| NYC suburbs and Long Island, NYNew York | $881.86 | $107.05 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $812.20 | $98.65 |
| Queens, NYNew York | $874.18 | $103.93 |
| Rest of New YorkNew York | $707.34 | $88.27 |
| OhioOhio | $684.25 | $89.29 |
| OklahomaOklahoma | $669.00 | $87.07 |
| Portland, OROregon | $818.25 | $94.27 |
| Rest of OregonOregon | $738.69 | $89.65 |
| Metropolitan Philadelphia, PAPennsylvania | $773.79 | $95.42 |
| Rest of PennsylvaniaPennsylvania | $687.22 | $89.00 |
| Puerto RicoPuerto Rico | $750.90 | $92.08 |
| Rhode IslandRhode Island | $766.28 | $93.13 |
| South CarolinaSouth Carolina | $690.64 | $88.52 |
| South DakotaSouth Dakota | $738.85 | $87.20 |
| TennesseeTennessee | $678.22 | $85.87 |
| Austin, TXTexas | $782.35 | $92.91 |
| Beaumont, TXTexas | $681.65 | $88.65 |
| Brazoria, TXTexas | $736.26 | $90.48 |
| Dallas, TXTexas | $740.27 | $91.23 |
| Fort Worth, TXTexas | $733.55 | $91.02 |
| Galveston, TXTexas | $737.96 | $90.87 |
| Houston, TXTexas | $741.81 | $94.72 |
| Rest of TexasTexas | $708.06 | $89.64 |
| UtahUtah | $701.89 | $89.33 |
| VirginiaVirginia | $729.85 | $89.28 |
| Virgin Islands, VIUnited States Virgin Islands | $750.90 | $92.08 |
| VermontVermont | $733.22 | $88.09 |
| Rest of WashingtonWashington | $778.67 | $92.48 |
| King County, WAWashington | $899.71 | $100.13 |
| WisconsinWisconsin | $710.02 | $85.74 |
| West VirginiaWest Virginia | $657.22 | $90.94 |
| WyomingWyoming | $741.68 | $90.03 |
45350 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.
$643.98
$927.11
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 | $812.05 | 1 |
| AL | $655.25 | 1 |
| AR | $643.98 | 1 |
| AZ | $721.36 | 1 |
| CA | $806.63–$1,047.59 | 29 |
| CO | $786.25 | 1 |
| CT | $798.56 | 1 |
| DC | $868.60 | 1 |
| DE | $734.89 | 1 |
| FL | $717.04–$782.18 | 3 |
| GA | $671.23–$755.99 | 2 |
| GU | $833.95 | 1 |
| HI | $833.95 | 1 |
| IA | $681.33 | 1 |
| ID | $685.27 | 1 |
| IL | $688.14–$767.71 | 4 |
| IN | $690.13 | 1 |
| KS | $674.58 | 1 |
| KY | $667.24 | 1 |
| LA | $664.81–$704.24 | 2 |
| MA | $779.09–$877.23 | 2 |
| MD | $751.66–$868.60 | 3 |
| ME | $686.32–$734.78 | 2 |
| MI | $685.10–$724.46 | 2 |
| MN | $758.34 | 1 |
| MO | $649.25–$710.80 | 3 |
| MS | $646.92 | 1 |
| MT | $743.49 | 1 |
| NC | $695.30 | 1 |
| ND | $739.34 | 1 |
| NE | $686.65 | 1 |
| NH | $770.58 | 1 |
| NJ | $809.09–$856.51 | 2 |
| NM | $688.33 | 1 |
| NV | $743.01 | 1 |
| NY | $707.34–$881.86 | 5 |
| OH | $684.25 | 1 |
| OK | $669.00 | 1 |
| OR | $738.69–$818.25 | 2 |
| PA | $687.22–$773.79 | 2 |
| PR | $750.90 | 1 |
| RI | $766.28 | 1 |
| SC | $690.64 | 1 |
| SD | $738.85 | 1 |
| TN | $678.22 | 1 |
| TX | $681.65–$782.35 | 8 |
| UT | $701.89 | 1 |
| VA | $729.85–$868.60 | 2 |
| VI | $750.90 | 1 |
| VT | $733.22 | 1 |
| WA | $778.67–$899.71 | 2 |
| WI | $710.02 | 1 |
| WV | $657.22 | 1 |
| WY | $741.68 | 1 |
How the 45350 rate is calculated
Each of 45350’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 · 45350
RVUs × geographic indexes × conversion factor
Work1.64
1.64 RVUs× 1.000 GPCI
Practice expense20.41
20.41 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
22.2600
Conversion factor
$33.4009
Medicare rate
$743.50
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
5,512
- Code
- 45350
- Physician work
- 1.64
- Practice expense
- 20.41
- Malpractice
- 0.21
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 | 1.64 | × 1.054 | 1.7286 |
| Practice expense | 20.41 | × 1.178 | 24.0430 |
| Malpractice | 0.21 | × 1.113 | 0.2337 |
| Total RVUs | 26.0053 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$868.60
Office: (1.64 × 1.054 + 20.41 × 1.178 + 0.21 × 1.113) × $33.4009 = $868.60
Facility: (1.64 × 1.054 + 0.9 × 1.178 + 0.21 × 1.113) × $33.4009 = $100.95
Payment rules and modifiers for 45350
The CMS indicators that decide how 45350 is paid alongside other services.
CMS payment indicators · 45350
Sigmoidoscopy, endoscopic band ligation
| 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
45350 without 51 · national office
$743.50
Sigmoidoscopy, endoscopic band ligation
45350-51 · Second procedure: 50%
$371.75
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 45350 has changed in Washington, DC area
45350 · Office / nonfacility
$868.60
Effective 2026-10-01
The base rate is $134.27 higher than on 2025-10-01, moving from $734.33 to $868.60 (18.3%).
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
$734.33changed to$868.60
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.68 changed to 1.64
- Practice expense RVU 17.34 changed to 20.41
- Malpractice RVU 0.22 changed to 0.21
- 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
$785.05changed to$734.33
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 18.07 changed to 17.34
- Malpractice RVU 0.23 changed to 0.22
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$772.23changed to$785.05
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$825.43changed to$772.23
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 18.38 changed to 18.07
- Malpractice RVU 0.22 changed to 0.23
- 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
$889.79changed to$825.43
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 19.15 changed to 18.38
- Malpractice RVU 0.21 changed to 0.22
- 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
$876.03changed to$889.79
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 18.66 changed to 19.15
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$774.82changed to$876.03
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 15.91 changed to 18.66
- Malpractice RVU 0.22 changed to 0.21
- 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
$703.00changed to$774.82
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 14.48 changed to 15.91
- Malpractice RVU 0.24 changed to 0.22
- 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
$644.10changed to$703.00
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 13.14 changed to 14.48
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$634.15changed to$644.10
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 12.96 changed to 13.14
- Malpractice RVU 0.23 changed to 0.24
- 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
$705.35changed to$634.15
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 1.78 changed to 1.68
- Practice expense RVU 14.52 changed to 12.96
- Malpractice RVU 0.26 changed to 0.23
- 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$705.35
Held through RVU16B, RVU16C, RVU16D.
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $868.60 | $100.95 | RVU26D |
| 2026-07-01 | $868.60 | $100.95 | RVU26C |
| 2026-04-01 | $868.60 | $100.95 | RVU26B |
| 2026-01-01 | $868.60 | $100.95 | RVU26A |
| 2025-10-01 | $734.33 | $108.16 | RVU25D |
| 2025-07-01 | $734.33 | $108.16 | RVU25C |
| 2025-04-01 | $734.33 | $108.16 | RVU25B |
| 2025-01-01 | $734.33 | $108.16 | RVU25A |
| 2024-10-01 | $785.05 | $111.30 | RVU24D |
| 2024-07-01 | $785.05 | $111.30 | RVU24C |
| 2024-04-01 | $785.05 | $111.30 | RVU24B |
| 2024-03-09 | $785.05 | $111.30 | RVU24AR |
| 2024-01-01 | $772.23 | $109.49 | RVU24A |
| 2023-10-01 | $825.43 | $112.90 | RVU23D |
| 2023-07-01 | $825.43 | $112.90 | RVU23C |
| 2023-04-01 | $825.43 | $112.90 | RVU23B |
| 2023-01-01 | $825.43 | $112.90 | RVU23A |
| 2022-10-01 | $889.79 | $116.02 | RVU22D |
| 2022-07-01 | $889.79 | $116.02 | RVU22C |
| 2022-04-01 | $889.79 | $116.02 | RVU22B |
| 2022-01-01 | $889.79 | $116.02 | RVU22A |
| 2021-10-01 | $876.03 | $116.12 | RVU21D |
| 2021-07-01 | $876.03 | $116.12 | RVU21C |
| 2021-04-01 | $876.03 | $116.12 | RVU21B |
| 2021-01-01 | $876.03 | $116.12 | RVU21A |
| 2020-10-01 | $774.82 | $118.69 | RVU20D |
| 2020-07-01 | $774.82 | $118.69 | RVU20C |
| 2020-04-01 | $774.82 | $118.69 | RVU20B |
| 2020-01-01 | $774.82 | $118.69 | RVU20A |
| 2019-10-01 | $703.00 | $118.47 | RVU19D |
| 2019-07-01 | $703.00 | $118.47 | RVU19C |
| 2019-04-01 | $703.00 | $118.47 | RVU19B |
| 2019-01-01 | $703.00 | $118.47 | RVU19A |
| 2018-10-01 | $644.10 | $119.21 | RVU18D |
| 2018-07-01 | $644.10 | $119.21 | RVU18C |
| 2018-04-01 | $644.10 | $119.21 | RVU18B |
| 2018-01-01 | $644.10 | $119.21 | RVU18AR1 |
| 2017-10-01 | $634.15 | $119.09 | RVU17D |
| 2017-07-01 | $634.15 | $119.09 | RVU17C |
| 2017-04-01 | $634.15 | $119.09 | RVU17B |
| 2017-01-01 | $634.15 | $119.09 | RVU17A |
| 2016-10-01 | $705.35 | $124.63 | RVU16D |
| 2016-07-01 | $705.35 | $124.63 | RVU16C |
| 2016-04-01 | $705.35 | $124.63 | RVU16B |
| 2016-01-01 | $705.35 | $124.63 | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | 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
45350 billing questions
When should I choose this over diagnostic sigmoidoscopy?
Use this code when the sigmoidoscopy includes band ligation. Diagnostic sigmoidoscopy describes examination without that therapeutic treatment.
Can diagnostic sigmoidoscopy be reported separately for the same session?
The examination needed to perform the band ligation is part of the therapeutic service. When related endoscopies are performed together, CMS endoscopy family pricing applies.
Is the code reported once for each band?
The code describes the band-ligation procedure, including placement of one or more bands. Document the treatment performed and target tissue.
Should modifier 50 be appended for treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be billed?
CMS does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing are not permitted.
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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