Billing code 45340: Sigmoidoscopy dilationMedicare rate & RVUs
Reports flexible sigmoidoscopy in which an endoscopist passes and inflates a balloon through the scope to widen a rectal or sigmoid stricture.
Medicare pays $507.36 for 45340 nationally in the office and $72.48 in a hospital or facility. Local office rates run $439.61–$712.94.
Medicare rate · 45340
Sigmoidoscopy dilation
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- Work RVUs
- 1.22
- Total RVUs
- 15.19
- Global days
- 000
National rate · 2026
$507.36
Office setting, before claim adjustments.
See every locality for 45340 → · 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 45340 covers
During flexible sigmoidoscopy, the endoscopist guides a dilation balloon through the scope to a narrowed area in the rectum or sigmoid colon, then inflates it under endoscopic visualization to enlarge the passage. Gastroenterologists and colorectal surgeons commonly perform this treatment for a stricture that limits passage through the distal bowel, including a narrowing at a surgical anastomosis. The procedure may take place in an endoscopy unit or hospital outpatient setting.
Report 45340 when the flexible sigmoidoscopy includes transendoscopic balloon dilation; diagnostic inspection alone is not the dilation service. The procedure note should identify the narrowed site and document balloon dilation. 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. Medicare does not pay an assistant at surgery for this code, and co-surgery 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 45340 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
$439.61 to $712.94
109 of 109 payment localities
45340 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.
$439.61
$631.31
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 | $555.15 | 1 |
| AL | $447.28 | 1 |
| AR | $439.61 | 1 |
| AZ | $492.25 | 1 |
| CA | $549.67–$712.94 | 29 |
| CO | $536.10 | 1 |
| CT | $544.86 | 1 |
| DC | $592.25 | 1 |
| DE | $501.46 | 1 |
| FL | $489.93–$534.94 | 3 |
| GA | $458.67–$516.00 | 2 |
| GU | $568.12 | 1 |
| HI | $568.12 | 1 |
| IA | $464.76 | 1 |
| ID | $467.49 | 1 |
| IL | $470.46–$524.47 | 4 |
| IN | $470.79 | 1 |
| KS | $460.29 | 1 |
| KY | $455.71 | 1 |
| LA | $454.11–$480.94 | 2 |
| MA | $531.29–$597.83 | 2 |
| MD | $512.83–$592.25 | 3 |
| ME | $468.34–$501.12 | 2 |
| MI | $467.99–$495.12 | 2 |
| MN | $516.73 | 1 |
| MO | $443.60–$485.25 | 3 |
| MS | $441.81 | 1 |
| MT | $507.35 | 1 |
| NC | $474.43 | 1 |
| ND | $503.99 | 1 |
| NE | $468.34 | 1 |
| NH | $525.55 | 1 |
| NJ | $551.95–$584.06 | 2 |
| NM | $470.24 | 1 |
| NV | $506.87 | 1 |
| NY | $482.63–$601.95 | 5 |
| OH | $467.30 | 1 |
| OK | $456.77 | 1 |
| OR | $503.83–$557.72 | 2 |
| PA | $469.25–$528.09 | 2 |
| PR | $512.34 | 1 |
| RI | $522.73 | 1 |
| SC | $471.48 | 1 |
| SD | $503.59 | 1 |
| TN | $462.79 | 1 |
| TX | $465.47–$533.53 | 8 |
| UT | $479.12 | 1 |
| VA | $497.85–$592.25 | 2 |
| VI | $512.34 | 1 |
| VT | $499.95 | 1 |
| WA | $530.96–$612.99 | 2 |
| WI | $484.07 | 1 |
| WV | $449.42 | 1 |
| WY | $505.88 | 1 |
How the 45340 rate is calculated
Each of 45340’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 · 45340
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.22Practice expense 13.80Malpractice 0.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45340
The CMS indicators that decide how 45340 is paid alongside other services.
CMS payment indicators · 45340
Sigmoidoscopy dilation
| 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
45340 without 51 · national office
$507.36
Sigmoidoscopy dilation
45340-51 · Second procedure: 50%
$253.68
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%).
45340 compared with similar codes
Compare codes
45340 vs 45386 vs 45303 vs 45330: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45386Colonoscopy
- 45386 describes transendoscopic balloon dilation during colonoscopy. Choose 45340 when the performed examination is flexible sigmoidoscopy.
- 45303Proctosigmoidoscopy
- 45303 describes dilation with proctosigmoidoscopy. 45340 is for balloon dilation performed through a flexible sigmoidoscope.
- 45330Flexible sigmoidoscopy
- 45330 is diagnostic flexible sigmoidoscopy; 45340 requires balloon dilation of a stricture during the examination.
45340 billing questions
When should 45340 be chosen over 45330?
Use 45340 when a balloon is passed through the flexible sigmoidoscope and inflated to widen a stricture. Use 45330 for diagnostic flexible sigmoidoscopy without that therapeutic dilation.
Can the diagnostic sigmoidoscopy be reported separately?
Inspection of the bowel as part of the dilation procedure is integral to reporting 45340. Do not separately report a diagnostic examination for that same scope passage.
What documentation supports 45340?
Document the stricture's location and the transendoscopic balloon dilation performed. The record should make clear that dilation, rather than inspection alone, was carried out.
Should modifier 50 be appended for a stricture on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the sigmoidoscopy dilation without modifier 50.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 45340. Co-surgeons and team surgery are not permitted 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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