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CMS RVU26D · Effective 2026-10-01

45305 in Chico

Office / nonfacility

$210.75

Base rate per service

Facility setting

$69.08

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.

Gastrointestinal endoscopy

About 45305: Rigid proctosigmoidoscopy with biopsy

Reports rigid examination of the rectum and distal sigmoid with tissue sampling to evaluate abnormal mucosa, a lesion, or another finding.

The clinician advances a rigid proctosigmoidoscope to inspect the rectum and distal sigmoid and takes one or more tissue samples during the examination. Common reasons include sampling abnormal mucosa, an ulcer, or a suspicious lesion. Gastroenterologists and colorectal surgeons may perform the procedure in an office or a facility-based endoscopy setting. The biopsy is part of this service; the code covers obtaining the sample, not the laboratory examination of the tissue.

Choose this code when the documented procedure uses a rigid scope and includes biopsy. A diagnostic rigid examination without biopsy is coded differently; a flexible sigmoidoscopy with biopsy is a different service. Record the scope type, examination performed, and biopsy site or sites. 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 for an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 45305

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 RVU1.12 · 19%
  • Practice expense (office) RVU4.62 · 78%
  • Malpractice RVU0.20 · 3%

351

Medicare services in 2024 · #3858 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.

45305 compared with similar codes

Office rates for Chico, from the same CMS release.

45300

Proctosigmoidoscopy

Rigid, diagnostic

$158.41

45300 is the diagnostic rigid examination without biopsy. Report 45305 when tissue is sampled during the rigid examination.

45331

Sigmoidoscopy

With biopsy

$348.45

45331 describes biopsy during flexible sigmoidoscopy. Choose based on the scope used, not simply on the fact that tissue was sampled.

45308

Lesion removal

Rigid scope, cautery technique

$239.03

45308 is for lesion removal by rigid proctosigmoidoscopy. Use 45305 when tissue is sampled rather than removed as a therapeutic lesion procedure.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 45305 is $211.31—$0.56 higher than the $210.75 rate in Chico. Both use the same code, release and participation basis.

45305 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $210.75

  2. Bakersfield

    $211.31

    $0.56 higher than Chico

  3. El Centro

    $210.79

    $0.04 higher than Chico

  4. Fresno

    $210.75

    The same base rate than Chico

  5. Hanford-Corcoran

    $210.75

    The same base rate than Chico

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $225.93

    $15.18 higher than Chico

  7. Madera

    $210.75

    The same base rate than Chico

Other payment areas listed in California 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, 45305 ranges from $173.40 in Arkansas to $267.62 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

  • Merced

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Modesto

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Napa

    California · 45305

    Office

    $246.54

    Facility

    $76.18

    $35.79 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45305

    Office

    $225.02

    Facility

    $72.23

    $14.27 higher than Chico for the office setting.

  • Redding

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45305

    Office

    $212.91

    Facility

    $71.24

    $2.16 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45305

    Office

    $221.80

    Facility

    $71.47

    $11.05 higher than Chico for the office setting.

  • Salinas

    California · 45305

    Office

    $221.00

    Facility

    $71.18

    $10.25 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45305

    Office

    $226.71

    Facility

    $72.11

    $15.96 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45305

    Office

    $261.61

    Facility

    $79.35

    $50.86 higher than Chico for the office setting.

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

    California · 45305

    Office

    $261.38

    Facility

    $79.12

    $50.63 higher than Chico for the office setting.

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

    California · 45305

    Office

    $267.62

    Facility

    $81.23

    $56.87 higher than Chico for the office setting.

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

    California · 45305

    Office

    $266.69

    Facility

    $80.30

    $55.94 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45305

    Office

    $217.39

    Facility

    $70.16

    $6.64 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 45305

    Office

    $229.26

    Facility

    $72.21

    $18.51 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 45305

    Office

    $221.97

    Facility

    $71.25

    $11.22 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 45305

    Office

    $231.61

    Facility

    $72.87

    $20.86 higher than Chico for the office setting.

  • Stockton

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 45305

    Office

    $246.22

    Facility

    $75.85

    $35.47 higher than Chico for the office setting.

  • Visalia

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 45305

    Office

    $210.75

    Facility

    $69.08

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45305

    Office

    $228.64

    Facility

    $76.37

    $17.89 higher than Chico for the office setting.

  • Miami

    Florida · 45305

    Office

    $214.94

    Facility

    $80.38

    $4.19 higher than Chico for the office setting.

  • Chicago

    Illinois · 45305

    Office

    $208.09

    Facility

    $78.18

    $2.66 lower than Chico for the office setting.

  • Manhattan

    New York · 45305

    Office

    $229.71

    Facility

    $79.51

    $18.96 higher than Chico for the office setting.

  • Alaska*

    Alaska · 45305

    Office

    $224.14

    Facility

    $86.47

    $13.39 higher than Chico for the office setting.

  • Alabama

    Alabama · 45305

    Office

    $176.21

    Facility

    $63.11

    $34.54 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 45305

    Office

    $173.40

    Facility

    $62.37

    $37.35 lower than Chico for the office setting.

  • Arizona

    Arizona · 45305

    Office

    $192.66

    Facility

    $67.40

    $18.09 lower than Chico for the office setting.

  • Colorado

    Colorado · 45305

    Office

    $207.26

    Facility

    $69.73

    $3.49 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 45305

    Office

    $212.43

    Facility

    $73.22

    $1.68 higher than Chico for the office setting.

  • Delaware

    Delaware · 45305

    Office

    $196.06

    Facility

    $68.35

    $14.69 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 45305

    Office

    $205.80

    Facility

    $74.86

    $4.95 lower than Chico for the office setting.

  • Rest Of Florida

    Florida · 45305

    Office

    $194.97

    Facility

    $71.40

    $15.78 lower than Chico for the office setting.

  • Atlanta

    Georgia · 45305

    Office

    $202.33

    Facility

    $71.00

    $8.42 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 45305

    Office

    $183.02

    Facility

    $67.72

    $27.73 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 45305

    Office

    $216.73

    Facility

    $69.76

    $5.98 higher than Chico for the office setting.

  • Iowa

    Iowa · 45305

    Office

    $181.26

    Facility

    $62.98

    $29.49 lower than Chico for the office setting.

  • Idaho

    Idaho · 45305

    Office

    $182.54

    Facility

    $63.62

    $28.21 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 45305

    Office

    $192.83

    Facility

    $73.91

    $17.92 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 45305

    Office

    $188.74

    Facility

    $70.72

    $22.01 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 45305

    Office

    $207.99

    Facility

    $75.24

    $2.76 lower than Chico for the office setting.

  • Indiana

    Indiana · 45305

    Office

    $183.70

    Facility

    $63.88

    $27.05 lower than Chico for the office setting.

  • Kansas

    Kansas · 45305

    Office

    $180.27

    Facility

    $63.42

    $30.48 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 45305

    Office

    $180.70

    Facility

    $65.79

    $30.05 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 45305

    Office

    $190.21

    Facility

    $68.57

    $20.54 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 45305

    Office

    $180.37

    Facility

    $65.98

    $30.38 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 45305

    Office

    $229.14

    Facility

    $74.80

    $18.39 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45305

    Office

    $205.82

    Facility

    $69.71

    $4.93 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45305

    Office

    $211.85

    Facility

    $73.15

    $1.10 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 45305

    Office

    $200.08

    Facility

    $69.27

    $10.67 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 45305

    Office

    $183.53

    Facility

    $64.61

    $27.22 lower than Chico for the office setting.

  • Southern Maine

    Maine · 45305

    Office

    $194.55

    Facility

    $66.45

    $16.20 lower than Chico for the office setting.

  • Detroit

    Michigan · 45305

    Office

    $197.58

    Facility

    $72.85

    $13.17 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 45305

    Office

    $185.84

    Facility

    $67.82

    $24.91 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 45305

    Office

    $198.17

    Facility

    $65.16

    $12.58 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 45305

    Office

    $188.83

    Facility

    $67.46

    $21.92 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 45305

    Office

    $191.01

    Facility

    $67.95

    $19.74 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 45305

    Office

    $176.93

    Facility

    $65.51

    $33.82 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 45305

    Office

    $175.21

    Facility

    $63.91

    $35.54 lower than Chico for the office setting.

  • Montana**

    Montana · 45305

    Office

    $198.39

    Facility

    $69.13

    $12.36 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 45305

    Office

    $185.65

    Facility

    $65.05

    $25.10 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 45305

    Office

    $194.43

    Facility

    $65.17

    $16.32 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 45305

    Office

    $182.36

    Facility

    $63.06

    $28.39 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 45305

    Office

    $203.89

    Facility

    $69.33

    $6.86 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 45305

    Office

    $225.90

    Facility

    $75.96

    $15.15 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 45305

    Office

    $214.74

    Facility

    $73.59

    $3.99 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 45305

    Office

    $186.94

    Facility

    $68.40

    $23.81 lower than Chico for the office setting.

  • Nevada**

    Nevada · 45305

    Office

    $197.44

    Facility

    $68.05

    $13.31 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45305

    Office

    $235.69

    Facility

    $81.99

    $24.94 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45305

    Office

    $216.15

    Facility

    $74.61

    $5.40 higher than Chico for the office setting.

  • Queens

    New York · 45305

    Office

    $231.83

    Facility

    $79.05

    $21.08 higher than Chico for the office setting.

  • Rest Of New York

    New York · 45305

    Office

    $188.70

    Facility

    $65.90

    $22.05 lower than Chico for the office setting.

  • Ohio

    Ohio · 45305

    Office

    $185.03

    Facility

    $67.01

    $25.72 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 45305

    Office

    $180.40

    Facility

    $64.97

    $30.35 lower than Chico for the office setting.

  • Portland

    Oregon · 45305

    Office

    $214.42

    Facility

    $70.81

    $3.67 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 45305

    Office

    $195.80

    Facility

    $67.06

    $14.95 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45305

    Office

    $206.69

    Facility

    $72.13

    $4.06 lower than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45305

    Office

    $185.38

    Facility

    $66.72

    $25.37 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 45305

    Office

    $200.00

    Facility

    $69.32

    $10.75 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 45305

    Office

    $203.48

    Facility

    $69.96

    $7.27 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 45305

    Office

    $185.67

    Facility

    $66.23

    $25.08 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 45305

    Office

    $193.97

    Facility

    $64.70

    $16.78 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 45305

    Office

    $181.27

    Facility

    $63.77

    $29.48 lower than Chico for the office setting.

  • Austin

    Texas · 45305

    Office

    $206.66

    Facility

    $69.91

    $4.09 lower than Chico for the office setting.

  • Beaumont

    Texas · 45305

    Office

    $184.04

    Facility

    $66.41

    $26.71 lower than Chico for the office setting.

  • Brazoria

    Texas · 45305

    Office

    $195.84

    Facility

    $67.74

    $14.91 lower than Chico for the office setting.

  • Dallas

    Texas · 45305

    Office

    $197.17

    Facility

    $68.43

    $13.58 lower than Chico for the office setting.

  • Fort Worth

    Texas · 45305

    Office

    $195.72

    Facility

    $68.26

    $15.03 lower than Chico for the office setting.

  • Galveston

    Texas · 45305

    Office

    $196.47

    Facility

    $68.11

    $14.28 lower than Chico for the office setting.

  • Houston

    Texas · 45305

    Office

    $200.13

    Facility

    $71.78

    $10.62 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 45305

    Office

    $189.88

    Facility

    $67.21

    $20.87 lower than Chico for the office setting.

  • Utah

    Utah · 45305

    Office

    $188.46

    Facility

    $66.96

    $22.29 lower than Chico for the office setting.

  • Virginia

    Virginia · 45305

    Office

    $193.81

    Facility

    $66.75

    $16.94 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45305

    Office

    $200.00

    Facility

    $69.32

    $10.75 lower than Chico for the office setting.

  • Vermont

    Vermont · 45305

    Office

    $193.56

    Facility

    $65.59

    $17.19 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 45305

    Office

    $205.47

    Facility

    $69.36

    $5.28 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 45305

    Office

    $234.08

    Facility

    $75.47

    $23.33 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 45305

    Office

    $187.30

    Facility

    $63.47

    $23.45 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 45305

    Office

    $181.07

    Facility

    $68.74

    $29.68 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 45305

    Office

    $196.66

    Facility

    $67.40

    $14.09 lower than Chico for the office setting.

See how rates vary across the country

45305 · 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.

$173.40

$239.19

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$224.141
AL$176.211
AR$173.401
AZ$192.661
CA$210.75–$267.6229
CO$207.261
CT$212.431
DC$228.641
DE$196.061
FL$194.97–$214.943
GA$183.02–$202.332
GU$216.731
HI$216.731
IA$181.261
ID$182.541
IL$188.74–$208.094
IN$183.701
KS$180.271
KY$180.701
LA$180.37–$190.212
MA$205.82–$229.142
MD$200.08–$228.643
ME$183.53–$194.552
MI$185.84–$197.582
MN$198.171
MO$176.93–$191.013
MS$175.211
MT$198.391
NC$185.651
ND$194.431
NE$182.361
NH$203.891
NJ$214.74–$225.902
NM$186.941
NV$197.441
NY$188.70–$235.695
OH$185.031
OK$180.401
OR$195.80–$214.422
PA$185.38–$206.692
PR$200.001
RI$203.481
SC$185.671
SD$193.971
TN$181.271
TX$184.04–$206.668
UT$188.461
VA$193.81–$228.642
VI$200.001
VT$193.561
WA$205.47–$234.082
WI$187.301
WV$181.071
WY$196.661

Explore 45305 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 45305 in Chico, the physician’s office rate is $210.75 and the facility-setting rate is $69.08: a difference of $141.67.

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 45305 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$231.83

$210.75 × 110% = $231.83

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 45305 in Chico.

PPRRVU2026_Oct_nonQPP.csv

5,489

Code
45305
Physician work
1.12
Practice expense
4.62
Malpractice
0.20

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 45305 in Chico
ComponentRVULocality factorAdjusted
Physician work1.12× 1.0171.1390
Practice expense4.62× 1.0965.0635
Malpractice0.20× 0.5360.1072
Total RVUs6.3098
Conversion factor× 33.4009

Office / nonfacility rate, Chico$210.75

Open 45305 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.121.017
Practice expense4.621.096
Malpractice0.20.536

(1.12 × 1.017 + 4.62 × 1.096 + 0.2 × 0.536) × $33.4009 = $210.75

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.121.017
Practice expense0.751.096
Malpractice0.20.536

(1.12 × 1.017 + 0.75 × 1.096 + 0.2 × 0.536) × $33.4009 = $69.08

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

45305 · Office / nonfacility

$210.75

Effective 2026-10-01

The base rate is $28.70 higher than on 2025-10-01, moving from $182.05 to $210.75 (15.8%).

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

    $182.05changed to$210.75

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.15 changed to 1.12
    • Practice expense RVU 3.98 changed to 4.62
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $182.05

    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$210.75$69.08RVU26D
2026-07-01$210.75$69.08RVU26C
2026-04-01$210.75$69.08RVU26B
2026-01-01$210.75$69.08RVU26A
2025-10-01$182.05$71.39RVU25D
2025-07-01$182.05$71.39RVU25C
2025-04-01$182.05$71.39RVU25B
2025-01-01$182.05$71.39RVU25A

45305 billing questions

How does this differ from 45300?

Use 45305 when the rigid proctosigmoidoscopy includes tissue sampling. Code 45300 describes the diagnostic rigid examination without biopsy.

Can I report this for a flexible sigmoidoscopy biopsy?

No. This code is for a rigid proctosigmoidoscopy with biopsy; 45331 is the corresponding flexible sigmoidoscopy biopsy service.

Is biopsy included in the procedure?

Yes. Obtaining the biopsy specimen is included in 45305. The tissue laboratory examination is a separate service when performed and reported by the appropriate laboratory provider.

Should modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this service, so do not use modifier 50.

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 service performed and do not assume each procedure receives independent full payment.

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 45305PPRRVU2026_Oct_nonQPP.csv, line 5,489 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet