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Billing code 45347: Sigmoidoscopy stentingMedicare rate & RVUs

Reports flexible sigmoidoscopy with placement of a stent across a narrowed large-bowel segment, commonly to relieve obstruction from a colorectal lesion.

CMS RVU26DEffective Oct 1, 2026109 payment localities552 Medicare services in 2024

Medicare pays $136.61 for 45347 nationally in a facility.

Medicare rate · 45347

Sigmoidoscopy stenting

Swap in your local Medicare rate.

Work RVUs
2.65
Total RVUs
4.09
Global days
000

National rate · 2026

$136.61

Facility setting, before claim adjustments.

See every locality for 45347 → · 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 45347 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 45347 covers

A gastroenterologist or colorectal surgeon advances a flexible endoscope through the rectum into the sigmoid or left colon and places a stent across a narrowed segment. A typical setting is a hospital or endoscopy unit treating a large-bowel obstruction, often from a colorectal tumor. The stent bridges the stenosis to restore or maintain passage through the bowel. Guidewire passage and dilation before or after stent placement, when performed, are part of this service.

Report 45347 when the documented procedure includes stent placement by flexible sigmoidoscopy, rather than diagnostic inspection alone or dilation without stenting. The operative report should identify the stenosis site and indication, scope used, and stent deployment. 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. CMS does not pay an assistant at surgery for this service; 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.

Where 45347 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

45347 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$127.50
Alaska*Unavailable$178.84
ArizonaUnavailable$133.99
ArkansasUnavailable$126.38
AtlantaUnavailable$139.50
AustinUnavailable$137.85
BakersfieldUnavailable$138.03
Baltimore/Surr. CntysUnavailable$143.18
BeaumontUnavailable$132.47
BrazoriaUnavailable$134.77

45347 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.

View every state and territory as a table
45347 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 45347 rate is calculated

Each of 45347’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 · 45347

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.65Practice expense 1.14Malpractice 0.30

4.0900 adjusted RVUs×$33.4009 conversion factor=$136.61

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 45347

The CMS indicators that decide how 45347 is paid alongside other services.

CMS payment indicators · 45347

Sigmoidoscopy stenting

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

45347 without 51 · national facility

$136.61

Sigmoidoscopy stenting

45347-51 · Second procedure: 50%

$68.31

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

45347 compared with similar codes

Compare codes

45347 vs 45327 vs 45330 vs 45340 vs 45389: national Medicare rates

Swap in your local Medicare rate.

  • 45347
    Sigmoidoscopy stenting · 2.65 wRVU
    —
  • 45327
    Stent placement · 1.85 wRVU
    —
  • 45330
    Flexible sigmoidoscopy · 0.82 wRVU
    $215.10
  • 45340
    Sigmoidoscopy dilation · 1.22 wRVU
    $507.36
  • 45389
    Colonoscopy · 5.11 wRVU
    —

How to choose

45327Stent placement
45327 uses rigid proctosigmoidoscopy for stent placement. 45347 describes stent placement using a flexible sigmoidoscope.
45330Flexible sigmoidoscopy
45330 is a diagnostic flexible sigmoidoscopy. It does not describe placement of a stent across a narrowing.
45340Sigmoidoscopy dilation
45340 covers balloon dilation of a narrowed segment; 45347 is selected when a stent is placed.
45389Colonoscopy
Both codes describe endoscopic stent placement, but 45389 uses a colonoscope while 45347 uses a flexible sigmoidoscope.

Codes related to 45347

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

Codes related to 45347
CodeHow it relatesNational office range
Same family
45327Stent placementStent placement by rigid proctosigmoidoscopy rather than flexible sigmoidoscopy.No office rate
45330Flexible sigmoidoscopyDiagnostic flexible sigmoidoscopy without the stent-placement service.$187.26–$297.45
45340Sigmoidoscopy dilationFlexible sigmoidoscopy with balloon dilation rather than stent placement.$439.61–$712.94
Used instead
45389ColonoscopyColonoscopy with stent placement when the procedure uses a colonoscope.No office rate

45347 billing questions

Is dilation separately reported with stent placement?

Pre- and post-dilation and guidewire passage, when performed as part of the stent procedure, are included in 45347. Do not separately report those components as though they were independent procedures.

How does 45347 differ from 45340?

45347 is for stent placement. Choose 45340 when the endoscopic treatment is balloon dilation of a narrowing and no stent is placed.

Can an assistant-at-surgery or co-surgeon be billed?

CMS does not pay an assistant at surgery for 45347. Co-surgeon and team-surgery billing are not permitted for this service.

What happens when another related endoscopy is performed in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together. Document each distinct service performed and the findings supporting it.

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 45347PPRRVU2026_Oct_nonQPP.csv, line 5,510 (RVU26D)

Open CMS sourceHow we calculate rates

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