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CMS RVU26D · Effective 2026-10-01

45309 in Beaumont

Office / nonfacility

$217.42

Base rate per service

Facility setting

$82.77

Base rate per service

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.

Lower endoscopy

About 45309: Rigid proctosigmoidoscopy with snare removal

Reports rigid proctosigmoidoscopy in which a clinician removes a rectal or distal sigmoid lesion using a snare.

A clinician uses a rigid proctosigmoidoscope to examine the rectum and distal sigmoid and remove a tumor, polyp, or other lesion with a snare. Gastroenterologists and colorectal or general surgeons may perform the procedure in an endoscopy unit, hospital, or office setting. The snare technique distinguishes this service from lesion removal by hot biopsy forceps or bipolar cautery and from flexible sigmoidoscopy.

Select the code when the procedure documentation supports rigid scope use and snare removal; record the lesion site, findings, and technique. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, Medicare endoscopy-family pricing applies. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery reporting are not permitted.

CMS billing rules for 45309

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 RVU1.37 · 20%
  • Practice expense (office) RVU5.27 · 75%
  • Malpractice RVU0.37 · 5%

20

Medicare services in 2024 · #5921 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.

45309 compared with similar codes

Office rates for Beaumont, from the same CMS release.

45308

Lesion removal

Rigid scope, cautery technique

$210.72

Both involve rigid proctosigmoidoscopy and lesion removal. Choose this code for snare technique; 45308 describes removal with hot biopsy forceps or bipolar cautery.

45315

Proctosigmoidoscopy

Snare removal of lesion

$233.83

This code describes snare removal. Code 45315 describes removal of multiple lesions by hot biopsy forceps during rigid proctosigmoidoscopy.

45338

Flexible sigmoidoscopy

Snare lesion removal

$311.03

Both describe snare removal, but 45309 is for rigid proctosigmoidoscopy and 45338 is for flexible sigmoidoscopy.

45305

Proctosigmoidoscopy

Rigid scope with biopsy

$184.04

Code 45305 is for biopsy during rigid proctosigmoidoscopy. Use this code when the documented service is snare removal of a lesion.

The same code, a different location

How does Beaumont compare?

In Austin, the office rate for 45309 is $243.03—$25.61 higher than the $217.42 rate in Beaumont. Both use the same code, release and participation basis.

45309 across payment areas

Same release and payment basis · bars start at $0

  1. Beaumont · This locality

    $217.42

  2. Austin

    $243.03

    $25.61 higher than Beaumont

  3. Brazoria

    $230.20

    $12.78 higher than Beaumont

  4. Dallas

    $232.09

    $14.67 higher than Beaumont

  5. Fort Worth

    $230.49

    $13.07 higher than Beaumont

  6. Galveston

    $231.15

    $13.73 higher than Beaumont

  7. Houston

    $237.92

    $20.50 higher than Beaumont

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 45309 ranges from $203.33 in Arkansas to $311.24 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 45309

    Office

    $223.96

    Facility

    $83.54

    $6.54 higher than Beaumont for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 45309

    Office

    $264.08

    Facility

    $89.03

    $46.66 higher than Beaumont for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45309

    Office

    $269.34

    Facility

    $95.04

    $51.92 higher than Beaumont for the office setting.

  • Miami

    Florida · 45309

    Office

    $260.25

    Facility

    $106.22

    $42.83 higher than Beaumont for the office setting.

  • Chicago

    Illinois · 45309

    Office

    $251.34

    Facility

    $102.64

    $33.92 higher than Beaumont for the office setting.

  • Manhattan

    New York · 45309

    Office

    $272.83

    Facility

    $100.89

    $55.41 higher than Beaumont for the office setting.

  • Alaska*

    Alaska · 45309

    Office

    $262.91

    Facility

    $105.33

    $45.49 higher than Beaumont for the office setting.

  • Alabama

    Alabama · 45309

    Office

    $206.77

    Facility

    $77.30

    $10.65 lower than Beaumont for the office setting.

  • Arkansas

    Arkansas · 45309

    Office

    $203.33

    Facility

    $76.22

    $14.09 lower than Beaumont for the office setting.

  • Arizona

    Arizona · 45309

    Office

    $226.90

    Facility

    $83.52

    $9.48 higher than Beaumont for the office setting.

  • Bakersfield

    California · 45309

    Office

    $247.08

    Facility

    $84.91

    $29.66 higher than Beaumont for the office setting.

  • Chico

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • El Centro

    California · 45309

    Office

    $246.14

    Facility

    $83.97

    $28.72 higher than Beaumont for the office setting.

  • Fresno

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Hanford-Corcoran

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Madera

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Merced

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Modesto

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Napa

    California · 45309

    Office

    $286.92

    Facility

    $91.90

    $69.50 higher than Beaumont for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45309

    Office

    $262.80

    Facility

    $87.90

    $45.38 higher than Beaumont for the office setting.

  • Redding

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Rest Of California

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45309

    Office

    $250.05

    Facility

    $87.87

    $32.63 higher than Beaumont for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45309

    Office

    $258.75

    Facility

    $86.66

    $41.33 higher than Beaumont for the office setting.

  • Salinas

    California · 45309

    Office

    $257.81

    Facility

    $86.32

    $40.39 higher than Beaumont for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45309

    Office

    $264.35

    Facility

    $87.39

    $46.93 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45309

    Office

    $303.97

    Facility

    $95.34

    $86.55 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 45309

    Office

    $303.55

    Facility

    $94.92

    $86.13 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 45309

    Office

    $311.24

    Facility

    $97.87

    $93.82 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 45309

    Office

    $309.52

    Facility

    $96.16

    $92.10 higher than Beaumont for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45309

    Office

    $253.65

    Facility

    $85.12

    $36.23 higher than Beaumont for the office setting.

  • Santa Cruz-Watsonville

    California · 45309

    Office

    $267.21

    Facility

    $87.43

    $49.79 higher than Beaumont for the office setting.

  • Santa Maria-Santa Barbara

    California · 45309

    Office

    $258.91

    Facility

    $86.38

    $41.49 higher than Beaumont for the office setting.

  • Santa Rosa-Petaluma

    California · 45309

    Office

    $269.91

    Facility

    $88.21

    $52.49 higher than Beaumont for the office setting.

  • Stockton

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Vallejo

    California · 45309

    Office

    $286.31

    Facility

    $91.29

    $68.89 higher than Beaumont for the office setting.

  • Visalia

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Yuba City

    California · 45309

    Office

    $246.08

    Facility

    $83.91

    $28.66 higher than Beaumont for the office setting.

  • Colorado

    Colorado · 45309

    Office

    $243.25

    Facility

    $85.81

    $25.83 higher than Beaumont for the office setting.

  • Connecticut

    Connecticut · 45309

    Office

    $251.20

    Facility

    $91.85

    $33.78 higher than Beaumont for the office setting.

  • Delaware

    Delaware · 45309

    Office

    $231.01

    Facility

    $84.82

    $13.59 higher than Beaumont for the office setting.

  • Fort Lauderdale

    Florida · 45309

    Office

    $246.41

    Facility

    $96.52

    $28.99 higher than Beaumont for the office setting.

  • Rest Of Florida

    Florida · 45309

    Office

    $232.61

    Facility

    $91.16

    $15.19 higher than Beaumont for the office setting.

  • Atlanta

    Georgia · 45309

    Office

    $239.58

    Facility

    $89.24

    $22.16 higher than Beaumont for the office setting.

  • Rest Of Georgia

    Georgia · 45309

    Office

    $217.50

    Facility

    $85.52

    $0.08 higher than Beaumont for the office setting.

  • Hawaii, Guam

    Hawaii · 45309

    Office

    $253.05

    Facility

    $84.82

    $35.63 higher than Beaumont for the office setting.

  • Iowa

    Iowa · 45309

    Office

    $211.73

    Facility

    $76.34

    $5.69 lower than Beaumont for the office setting.

  • Idaho

    Idaho · 45309

    Office

    $213.55

    Facility

    $77.42

    $3.87 lower than Beaumont for the office setting.

  • East St. Louis

    Illinois · 45309

    Office

    $232.59

    Facility

    $96.46

    $15.17 higher than Beaumont for the office setting.

  • Rest Of Illinois

    Illinois · 45309

    Office

    $225.78

    Facility

    $90.69

    $8.36 higher than Beaumont for the office setting.

  • Suburban Chicago

    Illinois · 45309

    Office

    $248.75

    Facility

    $96.79

    $31.33 higher than Beaumont for the office setting.

  • Indiana

    Indiana · 45309

    Office

    $214.94

    Facility

    $77.77

    $2.48 lower than Beaumont for the office setting.

  • Kansas

    Kansas · 45309

    Office

    $211.11

    Facility

    $77.35

    $6.31 lower than Beaumont for the office setting.

  • Kentucky

    Kentucky · 45309

    Office

    $213.55

    Facility

    $82.01

    $3.87 lower than Beaumont for the office setting.

  • New Orleans

    Louisiana · 45309

    Office

    $225.44

    Facility

    $86.20

    $8.02 higher than Beaumont for the office setting.

  • Rest Of Louisiana

    Louisiana · 45309

    Office

    $213.38

    Facility

    $82.43

    $4.04 lower than Beaumont for the office setting.

  • Metropolitan Boston

    Massachusetts · 45309

    Office

    $268.81

    Facility

    $92.13

    $51.39 higher than Beaumont for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45309

    Office

    $241.69

    Facility

    $85.88

    $24.27 higher than Beaumont for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45309

    Office

    $250.65

    Facility

    $91.88

    $33.23 higher than Beaumont for the office setting.

  • Rest Of Maryland

    Maryland · 45309

    Office

    $235.70

    Facility

    $85.96

    $18.28 higher than Beaumont for the office setting.

  • Rest Of Maine

    Maine · 45309

    Office

    $215.39

    Facility

    $79.26

    $2.03 lower than Beaumont for the office setting.

  • Southern Maine

    Maine · 45309

    Office

    $228.00

    Facility

    $81.36

    $10.58 higher than Beaumont for the office setting.

  • Detroit

    Michigan · 45309

    Office

    $236.46

    Facility

    $93.67

    $19.04 higher than Beaumont for the office setting.

  • Rest Of Michigan

    Michigan · 45309

    Office

    $220.42

    Facility

    $85.33

    $3.00 higher than Beaumont for the office setting.

  • Minnesota

    Minnesota · 45309

    Office

    $230.54

    Facility

    $78.29

    $13.12 higher than Beaumont for the office setting.

  • Metropolitan Kansas City

    Missouri · 45309

    Office

    $223.12

    Facility

    $84.18

    $5.70 higher than Beaumont for the office setting.

  • Metropolitan St. Louis

    Missouri · 45309

    Office

    $225.72

    Facility

    $84.85

    $8.30 higher than Beaumont for the office setting.

  • Rest Of Missouri

    Missouri · 45309

    Office

    $209.53

    Facility

    $81.98

    $7.89 lower than Beaumont for the office setting.

  • Mississippi

    Mississippi · 45309

    Office

    $206.45

    Facility

    $79.05

    $10.97 lower than Beaumont for the office setting.

  • Montana**

    Montana · 45309

    Office

    $234.12

    Facility

    $86.15

    $16.70 higher than Beaumont for the office setting.

  • North Carolina

    North Carolina · 45309

    Office

    $217.89

    Facility

    $79.83

    $0.47 higher than Beaumont for the office setting.

  • North Dakota**

    North Dakota · 45309

    Office

    $226.80

    Facility

    $78.83

    $9.38 higher than Beaumont for the office setting.

  • Nebraska

    Nebraska · 45309

    Office

    $212.90

    Facility

    $76.33

    $4.52 lower than Beaumont for the office setting.

  • New Hampshire

    New Hampshire · 45309

    Office

    $239.81

    Facility

    $85.78

    $22.39 higher than Beaumont for the office setting.

  • Northern Nj

    New Jersey · 45309

    Office

    $266.03

    Facility

    $94.39

    $48.61 higher than Beaumont for the office setting.

  • Rest Of New Jersey

    New Jersey · 45309

    Office

    $253.36

    Facility

    $91.78

    $35.94 higher than Beaumont for the office setting.

  • New Mexico

    New Mexico · 45309

    Office

    $222.01

    Facility

    $86.33

    $4.59 higher than Beaumont for the office setting.

  • Nevada**

    Nevada · 45309

    Office

    $232.25

    Facility

    $84.14

    $14.83 higher than Beaumont for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45309

    Office

    $280.93

    Facility

    $105.00

    $63.51 higher than Beaumont for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45309

    Office

    $255.52

    Facility

    $93.49

    $38.10 higher than Beaumont for the office setting.

  • Queens

    New York · 45309

    Office

    $274.57

    Facility

    $99.67

    $57.15 higher than Beaumont for the office setting.

  • Rest Of New York

    New York · 45309

    Office

    $221.67

    Facility

    $81.10

    $4.25 higher than Beaumont for the office setting.

  • Ohio

    Ohio · 45309

    Office

    $218.93

    Facility

    $83.83

    $1.51 higher than Beaumont for the office setting.

  • Oklahoma

    Oklahoma · 45309

    Office

    $212.55

    Facility

    $80.42

    $4.87 lower than Beaumont for the office setting.

  • Portland

    Oregon · 45309

    Office

    $251.25

    Facility

    $86.86

    $33.83 higher than Beaumont for the office setting.

  • Rest Of Oregon

    Oregon · 45309

    Office

    $229.77

    Facility

    $82.39

    $12.35 higher than Beaumont for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45309

    Office

    $244.57

    Facility

    $90.53

    $27.15 higher than Beaumont for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45309

    Office

    $219.03

    Facility

    $83.19

    $1.61 higher than Beaumont for the office setting.

  • Puerto Rico

    Puerto Rico · 45309

    Office

    $235.89

    Facility

    $86.30

    $18.47 higher than Beaumont for the office setting.

  • Rhode Island

    Rhode Island · 45309

    Office

    $239.48

    Facility

    $86.63

    $22.06 higher than Beaumont for the office setting.

  • South Carolina

    South Carolina · 45309

    Office

    $218.91

    Facility

    $82.19

    $1.49 higher than Beaumont for the office setting.

  • South Dakota**

    South Dakota · 45309

    Office

    $225.93

    Facility

    $77.97

    $8.51 higher than Beaumont for the office setting.

  • Tennessee

    Tennessee · 45309

    Office

    $212.40

    Facility

    $77.90

    $5.02 lower than Beaumont for the office setting.

  • Utah

    Utah · 45309

    Office

    $222.32

    Facility

    $83.23

    $4.90 higher than Beaumont for the office setting.

  • Virginia

    Virginia · 45309

    Office

    $227.51

    Facility

    $82.06

    $10.09 higher than Beaumont for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45309

    Office

    $235.89

    Facility

    $86.30

    $18.47 higher than Beaumont for the office setting.

  • Vermont

    Vermont · 45309

    Office

    $226.28

    Facility

    $79.79

    $8.86 higher than Beaumont for the office setting.

  • Rest Of Washington

    Washington · 45309

    Office

    $241.11

    Facility

    $85.30

    $23.69 higher than Beaumont for the office setting.

  • Seattle (King Cnty)

    Washington · 45309

    Office

    $274.12

    Facility

    $92.57

    $56.70 higher than Beaumont for the office setting.

  • Wisconsin

    Wisconsin · 45309

    Office

    $218.20

    Facility

    $76.44

    $0.78 higher than Beaumont for the office setting.

  • West Virginia

    West Virginia · 45309

    Office

    $216.41

    Facility

    $87.83

    $1.01 lower than Beaumont for the office setting.

  • Wyoming**

    Wyoming · 45309

    Office

    $230.93

    Facility

    $82.96

    $13.51 higher than Beaumont for the office setting.

See how rates vary across the country

45309 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$203.33

$278.66

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$262.911
AL$206.771
AR$203.331
AZ$226.901
CA$246.08–$311.2429
CO$243.251
CT$251.201
DC$269.341
DE$231.011
FL$232.61–$260.253
GA$217.50–$239.582
GU$253.051
HI$253.051
IA$211.731
ID$213.551
IL$225.78–$251.344
IN$214.941
KS$211.111
KY$213.551
LA$213.38–$225.442
MA$241.69–$268.812
MD$235.70–$269.343
ME$215.39–$228.002
MI$220.42–$236.462
MN$230.541
MO$209.53–$225.723
MS$206.451
MT$234.121
NC$217.891
ND$226.801
NE$212.901
NH$239.811
NJ$253.36–$266.032
NM$222.011
NV$232.251
NY$221.67–$280.935
OH$218.931
OK$212.551
OR$229.77–$251.252
PA$219.03–$244.572
PR$235.891
RI$239.481
SC$218.911
SD$225.931
TN$212.401
TX$217.42–$243.038
UT$222.321
VA$227.51–$269.342
VI$235.891
VT$226.281
WA$241.11–$274.122
WI$218.201
WV$216.411
WY$230.931

Explore 45309 on the national rate map →

Where does this rate apply?

Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 45309 in Beaumont, the physician’s office rate is $217.42 and the facility-setting rate is $82.77: a difference of $134.65.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 45309 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$239.16

$217.42 × 110% = $239.16

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 45309 in Beaumont.

PPRRVU2026_Oct_nonQPP.csv

5,492

Code
45309
Physician work
1.37
Practice expense
5.27
Malpractice
0.37

GPCI2026.csv

97

Locality
Beaumont
Physician work
1.000
Practice expense
0.910
Malpractice
0.929
Office / nonfacility calculation for 45309 in Beaumont
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense5.27× 0.9104.7957
Malpractice0.37× 0.9290.3437
Total RVUs6.5094
Conversion factor× 33.4009

Office / nonfacility rate, Beaumont$217.42

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Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.371
Practice expense5.270.91
Malpractice0.370.929

(1.37 × 1 + 5.27 × 0.91 + 0.37 × 0.929) × $33.4009 = $217.42

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.371
Practice expense0.840.91
Malpractice0.370.929

(1.37 × 1 + 0.84 × 0.91 + 0.37 × 0.929) × $33.4009 = $82.77

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

45309 · Office / nonfacility

$217.42

Effective 2026-10-01

The base rate is $29.96 higher than on 2025-10-01, moving from $187.46 to $217.42 (16.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $187.46changed to$217.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.40 changed to 1.37
    • Practice expense RVU 4.49 changed to 5.27
    • Malpractice RVU 0.36 changed to 0.37
    • Practice expense GPCI 0.903 changed to 0.910
    • Malpractice GPCI 0.947 changed to 0.929

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $187.46

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$217.42$82.77RVU26D
2026-07-01$217.42$82.77RVU26C
2026-04-01$217.42$82.77RVU26B
2026-01-01$217.42$82.77RVU26A
2025-10-01$187.46$84.35RVU25D
2025-07-01$187.46$84.35RVU25C
2025-04-01$187.46$84.35RVU25B
2025-01-01$187.46$84.35RVU25A

45309 billing questions

How does this differ from code 45308?

This code identifies snare removal during rigid proctosigmoidoscopy. Code 45308 is for lesion removal using hot biopsy forceps or bipolar cautery.

Can this code describe flexible sigmoidoscopy with snare removal?

No. This code is for rigid proctosigmoidoscopy; flexible sigmoidoscopy with snare removal is reported with code 45338.

What documentation supports the code?

Document that a rigid proctosigmoidoscope was used and that a lesion was removed with a snare. Include the lesion location and procedural findings.

Can modifier 50 be used?

No. Modifier 50 is inappropriate for this rectal and distal sigmoid service.

How are related endoscopies priced when performed together?

Medicare endoscopy-family pricing applies when related endoscopies are performed together. The payment calculation follows that family pricing rather than treating each as an unrelated procedure.

Is an assistant or co-surgeon payable for this procedure?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery reporting are not permitted.

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.

RVUs for 45309PPRRVU2026_Oct_nonQPP.csv, line 5,492 (RVU26D)
Geographic factors for BeaumontGPCI2026.csv, line 97 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet