No office rate
Both describe endoscopic decompression, but 45321 is for rigid proctosigmoidoscopy. Select 45337 when a flexible sigmoidoscope is used.
On this page
CMS RVU26D · Effective 2026-10-01
45337 Sigmoidoscopy Medicare reimbursement rates
Flexible sigmoidoscopy with decompression is reported when an endoscopist relieves colonic distention, commonly during endoscopic management of sigmoid volvulus. Compare 45337 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 45337?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 45337 pays more and less
Gastrointestinal endoscopy
About 45337: Flexible sigmoidoscopic decompression
Flexible sigmoidoscopy with decompression is reported when an endoscopist relieves colonic distention, commonly during endoscopic management of sigmoid volvulus.
A physician advances a flexible endoscope through the rectum into the distal colon to relieve distention, often in a patient with acute sigmoid volvulus. The endoscopist may use suction and endoscopic maneuvers to decompress the affected segment; a decompression tube may also be used when clinically indicated. Gastroenterologists and colorectal surgeons commonly perform this service in a hospital setting for an urgent obstruction-related presentation.
Report this code when the documented service includes therapeutic decompression, rather than inspection alone or another distinct intervention such as biopsy or bleeding control. The procedure note should support the indication, scope used, relevant findings, and decompression performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this service; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 45337
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.05 · 69%
- Practice expense (office) RVU0.70 · 23%
- Malpractice RVU0.24 · 8%
1.8K
Medicare services in 2024 · #2561 by national volume
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.
45337 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$187.26–$297.45
45330 represents diagnostic flexible sigmoidoscopy. Choose 45337 when the procedure includes therapeutic decompression, not inspection alone.
$281.06–$449.20
45331 is used when flexible sigmoidoscopy includes biopsy. Decompression, rather than tissue sampling, distinguishes 45337.
$474.04–$756.31
45334 describes endoscopic control of bleeding during flexible sigmoidoscopy. Use 45337 for decompression instead.
See how rates vary across the country
45337 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 45337 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $93.47 |
| Alaska* | Office Unavailable | Facility $132.03 |
| Arizona | Office Unavailable | Facility $97.99 |
| Arkansas | Office Unavailable | Facility $92.68 |
| Atlanta | Office Unavailable | Facility $102.06 |
| Austin | Office Unavailable | Facility $100.45 |
| Bakersfield | Office Unavailable | Facility $100.28 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $104.57 |
| Beaumont | Office Unavailable | Facility $97.20 |
| Brazoria | Office Unavailable | Facility $98.44 |
| Chicago | Office Unavailable | Facility $110.85 |
| Chico | Office Unavailable | Facility $99.56 |
| Colorado | Office Unavailable | Facility $100.43 |
| Connecticut | Office Unavailable | Facility $104.72 |
| Dallas | Office Unavailable | Facility $99.25 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $108.63 |
| Delaware | Office Unavailable | Facility $99.12 |
| Detroit | Office Unavailable | Facility $104.55 |
| East St. Louis | Office Unavailable | Facility $106.13 |
| El Centro | Office Unavailable | Facility $99.60 |
| Fort Lauderdale | Office Unavailable | Facility $106.65 |
| Fort Worth | Office Unavailable | Facility $99.12 |
| Fresno | Office Unavailable | Facility $99.56 |
| Galveston | Office Unavailable | Facility $98.87 |
| Hanford-Corcoran | Office Unavailable | Facility $99.56 |
| Hawaii, Guam | Office Unavailable | Facility $99.70 |
| Houston | Office Unavailable | Facility $103.27 |
| Idaho | Office Unavailable | Facility $93.77 |
| Indiana | Office Unavailable | Facility $94.04 |
| Iowa | Office Unavailable | Facility $93.05 |
| Kansas | Office Unavailable | Facility $93.65 |
| Kentucky | Office Unavailable | Facility $96.59 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $104.26 |
| Madera | Office Unavailable | Facility $99.56 |
| Manhattan | Office Unavailable | Facility $112.74 |
| Merced | Office Unavailable | Facility $99.56 |
| Metropolitan Boston | Office Unavailable | Facility $106.33 |
| Metropolitan Kansas City | Office Unavailable | Facility $98.26 |
| Metropolitan Philadelphia | Office Unavailable | Facility $103.61 |
| Metropolitan St. Louis | Office Unavailable | Facility $98.76 |
| Miami | Office Unavailable | Facility $113.08 |
| Minnesota | Office Unavailable | Facility $94.90 |
| Mississippi | Office Unavailable | Facility $94.53 |
| Modesto | Office Unavailable | Facility $99.56 |
| Montana** | Office Unavailable | Facility $99.85 |
| Napa | Office Unavailable | Facility $107.67 |
| Nebraska | Office Unavailable | Facility $93.08 |
| Nevada** | Office Unavailable | Facility $98.55 |
| New Hampshire | Office Unavailable | Facility $99.83 |
| New Mexico | Office Unavailable | Facility $99.54 |
| New Orleans | Office Unavailable | Facility $99.58 |
| North Carolina | Office Unavailable | Facility $95.41 |
| North Dakota** | Office Unavailable | Facility $95.11 |
| Northern Nj | Office Unavailable | Facility $108.47 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $115.54 |
| Ohio | Office Unavailable | Facility $97.90 |
| Oklahoma | Office Unavailable | Facility $95.58 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $103.02 |
| Portland | Office Unavailable | Facility $101.51 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $106.85 |
| Puerto Rico | Office Unavailable | Facility $100.01 |
| Queens | Office Unavailable | Facility $112.05 |
| Redding | Office Unavailable | Facility $99.56 |
| Rest Of California | Office Unavailable | Facility $99.56 |
| Rest Of Florida | Office Unavailable | Facility $102.87 |
| Rest Of Georgia | Office Unavailable | Facility $98.88 |
| Rest Of Illinois | Office Unavailable | Facility $102.35 |
| Rest Of Louisiana | Office Unavailable | Facility $96.84 |
| Rest Of Maine | Office Unavailable | Facility $94.97 |
| Rest Of Maryland | Office Unavailable | Facility $100.18 |
| Rest Of Massachusetts | Office Unavailable | Facility $100.58 |
| Rest Of Michigan | Office Unavailable | Facility $98.87 |
| Rest Of Missouri | Office Unavailable | Facility $96.43 |
| Rest Of New Jersey | Office Unavailable | Facility $105.54 |
| Rest Of New York | Office Unavailable | Facility $96.32 |
| Rest Of Oregon | Office Unavailable | Facility $97.39 |
| Rest Of Pennsylvania | Office Unavailable | Facility $97.51 |
| Rest Of Texas | Office Unavailable | Facility $97.90 |
| Rest Of Washington | Office Unavailable | Facility $100.08 |
| Rhode Island | Office Unavailable | Facility $101.08 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $102.17 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $102.43 |
| Salinas | Office Unavailable | Facility $101.99 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $102.83 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $111.62 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $111.35 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $114.02 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $112.90 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $100.56 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $102.61 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $101.95 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $103.53 |
| Seattle (King Cnty) | Office Unavailable | Facility $107.13 |
| South Carolina | Office Unavailable | Facility $96.89 |
| South Dakota** | Office Unavailable | Facility $94.55 |
| Southern Maine | Office Unavailable | Facility $96.70 |
| Stockton | Office Unavailable | Facility $99.56 |
| Suburban Chicago | Office Unavailable | Facility $107.17 |
| Tennessee | Office Unavailable | Facility $94.03 |
| Utah | Office Unavailable | Facility $97.65 |
| Vallejo | Office Unavailable | Facility $107.28 |
| Vermont | Office Unavailable | Facility $95.67 |
| Virgin Islands | Office Unavailable | Facility $100.01 |
| Virginia | Office Unavailable | Facility $97.11 |
| Visalia | Office Unavailable | Facility $99.56 |
| West Virginia | Office Unavailable | Facility $100.26 |
| Wisconsin | Office Unavailable | Facility $93.34 |
| Wyoming** | Office Unavailable | Facility $97.78 |
| Yuba City | Office Unavailable | Facility $99.56 |
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45337 billing questions
Can a biopsy or bleeding-control service be reported in the same session?
A separately performed intervention must be supported by the procedure documentation. When related endoscopies are performed together, CMS endoscopy-family pricing applies.
Can modifier 50 be appended?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
Is assistant-at-surgery payment available?
No. CMS applies a statutory restriction to assistant-at-surgery payment for this code; co-surgeons and team surgery are also not permitted.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,50145333,,Sigmoidoscopy & polypectomy,A,,1.51,9.29,,0.86,,0.22,11.02,2.59,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50245334,,Sigmoidoscopy for bleeding,A,,1.95,14.12,,1.00,,0.22,16.29,3.17,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50345335,,Sigmoidoscopy w/submuc inj,A,,1.01,8.67,,0.72,,0.14,9.82,1.87,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50445337,,Sigmoidoscopy & decompress,A,,2.05,0.70,NA,0.70,,0.24,2.99,2.99,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50545338,,Sigmoidoscopy w/tumr remove,A,,2.00,7.78,,1.01,,0.25,10.03,3.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50645340,,Sig w/tndsc balloon dilation,A,,1.22,13.80,,0.78,,0.17,15.19,2.17,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50745341,,Sigmoidoscopy w/ultrasound,A,,2.07,1.04,NA,1.04,,0.23,3.34,3.34,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00