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CPT code 45341: Sigmoidoscopy ultrasound2026 Medicare rate & RVUs

Reports flexible sigmoidoscopy with endoscopic ultrasound to evaluate rectal or distal colonic wall layers and nearby structures.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.7K Medicare services in 2024

Medicare pays $111.56 for 45341 nationally in a facility.

Medicare rate · 45341

Sigmoidoscopy ultrasound

Work RVUs
2.07
Total RVUs
3.34
Global days
000

National rate · 2026

$111.56

Facility setting, before claim adjustments.

See every locality for 45341 →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
  1. Medicare rate
  2. What 45341 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 45341 covers

A flexible sigmoidoscope equipped for endoscopic ultrasound is advanced into the rectum or sigmoid colon. The ultrasound images help assess bowel-wall layers and nearby tissues, such as when evaluating a rectal lesion or local disease extent. Gastroenterologists and other physicians trained in endoscopic ultrasound typically perform the service in an outpatient endoscopy unit or hospital facility.

Report 45341 when the endoscopic ultrasound examination is performed; it does not describe ultrasound-guided needle sampling, which is represented by 45342. Document the scope extent, ultrasound findings, and clinical target. The code has 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, 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.

Where 45341 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

45341 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$103.88
Alaska*Unavailable$144.94
ArizonaUnavailable$109.38
ArkansasUnavailable$102.94
AtlantaUnavailable$113.87
AustinUnavailable$112.84
BakersfieldUnavailable$113.20
Baltimore/Surr. CntysUnavailable$117.02
BeaumontUnavailable$107.89
BrazoriaUnavailable$110.11

45341 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
45341 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 45341 rate is calculated

Each of 45341’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 · 45341

RVUs × geographic indexes × conversion factor

Work2.07

2.07 RVUs× 1.000 GPCI

Practice expense1.04

1.04 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

3.3400

Conversion factor

$33.4009

Medicare rate

$111.56

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 45341

The CMS indicators that decide how 45341 is paid alongside other services.

CMS payment indicators · 45341

Sigmoidoscopy ultrasound

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45341 without 51 · national facility

$111.56

Sigmoidoscopy ultrasound

45341-51 · Second procedure: 50%

$55.78

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%).

When to use modifier 51

45341 compared with similar codes

Compare codes · National

5 codes, side by side

  • 45341

    Sigmoidoscopy ultrasound2.07 wRVU

    Not priced

  • 45342

    Sigmoidoscopy2.91 wRVU

    Not priced

  • 45330

    Flexible sigmoidoscopy0.82 wRVU

    $215.10

  • 45331

    Sigmoidoscopy1.11 wRVU

    $322.99

  • 45378

    Colonoscopy3.18 wRVU

    $378.10

How to choose

45342Sigmoidoscopy
45341 covers the endoscopic ultrasound examination; 45342 is for ultrasound-guided fine-needle aspiration or biopsy.
45330Flexible sigmoidoscopy
45330 is diagnostic flexible sigmoidoscopy without endoscopic ultrasound. Choose 45341 when the ultrasound examination is performed.
45331Sigmoidoscopy
45331 reports flexible sigmoidoscopy with biopsy. It does not represent an endoscopic ultrasound examination or ultrasound-guided sampling.
45378Colonoscopy
45378 describes diagnostic colonoscopy, a more extensive colonic examination; it does not describe rectal or sigmoid endoscopic ultrasound.

Codes related to 45341

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 45341
CodeHow it relatesNational office range
Same family
45342SigmoidoscopyAdds ultrasound-guided fine-needle aspiration or biopsy to the sigmoidoscopy ultrasound service.No office rate
Used instead
45330Flexible sigmoidoscopyUse for diagnostic flexible sigmoidoscopy without endoscopic ultrasound.$187.26–$297.45
45331SigmoidoscopyReports flexible sigmoidoscopy with biopsy when the service is not ultrasound-guided.$281.06–$449.20
45333Flexible sigmoidoscopyReports flexible sigmoidoscopy with polyp removal rather than ultrasound examination.$320.76–$507.37

45341 billing questions

How does 45341 differ from 45342?

45341 reports the endoscopic ultrasound examination. Use 45342 when the ultrasound guides fine-needle aspiration or biopsy.

Can I also report diagnostic sigmoidoscopy for the same session?

The sigmoidoscopy is part of 45341. Do not separately report a diagnostic sigmoidoscopy code for the same examination.

What documentation supports 45341?

Document the sigmoidoscope examination, the rectal or sigmoid ultrasound target, and the relevant ultrasound findings.

Should modifier 50 be appended?

No. CMS identifies bilateral adjustment as inapplicable to this code.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure.

How are related endoscopies priced when performed together?

CMS applies endoscopy family pricing when related endoscopies are performed together.

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
RVUs for 45341PPRRVU2026_Oct_nonQPP.csv, line 5,507 (RVU26D)

Open CMS sourceHow we calculate rates

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