Billing code 45315: ProctosigmoidoscopyMedicare rate & RVUs
Report this service when a clinician uses a rigid proctosigmoidoscope to remove a rectal or distal sigmoid polyp or other lesion with a snare.
Medicare pays $251.17 for 45315 nationally in the office and $100.20 in a hospital or facility. Local office rates run $218.64–$330.77.
Medicare rate · 45315
Proctosigmoidoscopy
Swap in your local Medicare rate.
- Work RVUs
- 1.66
- Total RVUs
- 7.52
- Global days
- 000
National rate · 2026
$251.17
Office setting, before claim adjustments.
See every locality for 45315 → · Billed by an NP, PA or therapist? →
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 10 sections
What 45315 covers
This procedure combines examination through a rigid proctosigmoidoscope with snare removal of a lesion in the rectum or distal sigmoid colon. A colorectal surgeon or gastroenterologist may perform it when a polyp can be reached through the rigid instrument. The procedure may take place in an office or outpatient facility, depending on the patient and setting.
Select this code from the operative note’s scope type, lesion location, and removal technique; a flexible sigmoidoscope or biopsy alone points to a different code. The diagnostic examination inherent in the removal is included. When related endoscopies are performed together, CMS applies endoscopy family pricing rather than simply adding their full payments. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this anatomy. CMS does not pay an assistant at surgery for this code and does not permit co-surgeons or team surgery.
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 45315 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$218.64 to $330.77
109 of 109 payment localities
45315 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$218.64
$296.82
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 | $284.24 | 1 |
| AL | $222.27 | 1 |
| AR | $218.64 | 1 |
| AZ | $243.48 | 1 |
| CA | $262.86–$330.77 | 29 |
| CO | $260.30 | 1 |
| CT | $269.27 | 1 |
| DC | $288.08 | 1 |
| DE | $247.82 | 1 |
| FL | $250.42–$280.57 | 3 |
| GA | $234.34–$257.13 | 2 |
| GU | $269.98 | 1 |
| HI | $269.98 | 1 |
| IA | $227.10 | 1 |
| ID | $229.10 | 1 |
| IL | $243.48–$271.07 | 4 |
| IN | $230.55 | 1 |
| KS | $226.64 | 1 |
| KY | $229.82 | 1 |
| LA | $229.71–$242.43 | 2 |
| MA | $258.76–$287.05 | 2 |
| MD | $252.73–$288.08 | 3 |
| ME | $231.24–$244.24 | 2 |
| MI | $237.25–$254.68 | 2 |
| MN | $246.32 | 1 |
| MO | $225.77–$242.50 | 3 |
| MS | $222.22 | 1 |
| MT | $251.15 | 1 |
| NC | $233.84 | 1 |
| ND | $242.64 | 1 |
| NE | $228.28 | 1 |
| NH | $256.82 | 1 |
| NJ | $271.47–$284.66 | 2 |
| NM | $239.01 | 1 |
| NV | $248.96 | 1 |
| NY | $237.84–$301.31 | 5 |
| OH | $235.51 | 1 |
| OK | $228.57 | 1 |
| OR | $246.18–$268.52 | 2 |
| PA | $235.51–$262.38 | 2 |
| PR | $252.95 | 1 |
| RI | $256.66 | 1 |
| SC | $235.24 | 1 |
| SD | $241.64 | 1 |
| TN | $228.02 | 1 |
| TX | $233.83–$260.17 | 8 |
| UT | $238.83 | 1 |
| VA | $243.87–$288.08 | 2 |
| VI | $252.95 | 1 |
| VT | $242.27 | 1 |
| WA | $258.08–$292.49 | 2 |
| WI | $233.62 | 1 |
| WV | $233.61 | 1 |
| WY | $247.44 | 1 |
How the 45315 rate is calculated
Each of 45315’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 · 45315
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.66Practice expense 5.43Malpractice 0.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45315
The CMS indicators that decide how 45315 is paid alongside other services.
CMS payment indicators · 45315
Proctosigmoidoscopy
| 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
45315 without 51 · national office
$251.17
Proctosigmoidoscopy
45315-51 · Second procedure: 50%
$125.59
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%).
45315 compared with similar codes
Compare codes
45315 vs 45338 vs 45305 vs 45300: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45338Flexible sigmoidoscopy
- Both involve snare removal, but 45315 uses a rigid proctosigmoidoscope; 45338 uses a flexible sigmoidoscope.
- 45305Proctosigmoidoscopy
- Choose 45305 for a biopsy through a rigid proctosigmoidoscope, rather than removal of a lesion with a snare.
- 45300Proctosigmoidoscopy
- 45300 represents the diagnostic rigid examination. Use 45315 when that examination includes documented snare removal.
45315 billing questions
How is 45315 distinguished from flexible sigmoidoscopy with snare removal?
Use 45315 when the documented instrument is a rigid proctosigmoidoscope. Flexible sigmoidoscopy with snare removal is reported with 45338.
Is a diagnostic rigid proctosigmoidoscopy separately reported with 45315?
The examination performed as part of the snare removal is included. If another related endoscopy is separately reportable during the same session, CMS endoscopy family pricing applies.
What documentation supports 45315?
The procedure note should identify the rigid scope, the rectal or distal sigmoid lesion, and removal with a snare.
Does the 0-day global period include care on the procedure date?
Yes. Same-day preoperative and postoperative care for this minor procedure is included.
Can modifier 50 or surgical team billing be used for 45315?
Modifier 50 is inappropriate for this anatomy. CMS does not pay an assistant at surgery and does not permit co-surgeons or team surgery 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
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