On this page

CMS RVU26D · Effective 2026-10-01

45335 in Chico

Office / nonfacility

$354.20

Base rate per service

Facility setting

$63.17

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 45335: Flexible sigmoidoscopy with submucosal injection

Reports flexible sigmoidoscopy when the endoscopist injects a substance into the bowel-wall submucosa, such as to mark or lift a target.

During flexible sigmoidoscopy, the endoscopist advances a flexible instrument through the rectum into the sigmoid colon and injects a substance beneath the mucosal lining under direct visualization. Injections may mark a site for later identification or raise a lesion for endoscopic treatment. Gastroenterologists and colorectal surgeons commonly perform the service in an endoscopy unit, ambulatory surgery center, or hospital outpatient department.

Report this code when the documented sigmoidoscopy includes submucosal injection; a diagnostic examination alone, biopsy, or removal is a different service. The procedure note should identify the injection site, substance or purpose when known, and the endoscopic work performed. 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. CMS does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 45335

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 RVU1.01 · 10%
  • Practice expense (office) RVU8.67 · 88%
  • Malpractice RVU0.14 · 1%

3.1K

Medicare services in 2024 · #2154 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.

45335 compared with similar codes

Office rates for Chico, from the same CMS release.

45330

Flexible sigmoidoscopy

Diagnostic

$231.34

Use 45330 for diagnostic flexible sigmoidoscopy without a separately described therapeutic intervention. Use 45335 when submucosal injection is performed.

45331

Sigmoidoscopy

With biopsy

$348.45

45331 represents sigmoidoscopy with biopsy. Choose 45335 for submucosal injection, not tissue sampling.

45333

Flexible sigmoidoscopy

Hot biopsy forceps removal

$395.31

45333 is for sigmoidoscopy with polyp removal. An injection to mark or lift a target, without removal, is the distinguishing service for 45335.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 45335 is $354.61—$0.41 higher than the $354.20 rate in Chico. Both use the same code, release and participation basis.

45335 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $354.20

  2. $0.41 higher than Chico

  3. El Centro

    $354.22

    $0.02 higher than Chico

  4. Fresno

    $354.20

    The same base rate than Chico

  5. The same base rate than Chico

  6. $26.60 higher than Chico

  7. Madera

    $354.20

    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, 45335 ranges from $284.90 in Arkansas to $457.53 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 · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Modesto

    California · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Napa

    California · 45335

    Office

    $419.91

    Facility

    $69.93

    $65.71 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45335

    Office

    $379.88

    Facility

    $66.02

    $25.68 higher than Chico for the office setting.

  • Redding

    California · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45335

    Office

    $355.72

    Facility

    $64.69

    $1.52 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45335

    Office

    $374.24

    Facility

    $65.42

    $20.04 higher than Chico for the office setting.

  • Salinas

    California · 45335

    Office

    $372.92

    Facility

    $65.16

    $18.72 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45335

    Office

    $383.63

    Facility

    $66.04

    $29.43 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45335

    Office

    $447.40

    Facility

    $72.99

    $93.20 higher than Chico for the office setting.

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

    California · 45335

    Office

    $447.24

    Facility

    $72.84

    $93.04 higher than Chico for the office setting.

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

    California · 45335

    Office

    $457.53

    Facility

    $74.63

    $103.33 higher than Chico for the office setting.

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

    California · 45335

    Office

    $456.88

    Facility

    $73.98

    $102.68 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45335

    Office

    $366.65

    Facility

    $64.21

    $12.45 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 45335

    Office

    $388.80

    Facility

    $66.17

    $34.60 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 45335

    Office

    $374.84

    Facility

    $65.23

    $20.64 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 45335

    Office

    $392.86

    Facility

    $66.79

    $38.66 higher than Chico for the office setting.

  • Stockton

    California · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 45335

    Office

    $419.68

    Facility

    $69.70

    $65.48 higher than Chico for the office setting.

  • Visalia

    California · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 45335

    Office

    $354.20

    Facility

    $63.17

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45335

    Office

    $381.89

    Facility

    $69.09

    $27.69 higher than Chico for the office setting.

  • Miami

    Florida · 45335

    Office

    $347.02

    Facility

    $70.60

    $7.18 lower than Chico for the office setting.

  • Chicago

    Illinois · 45335

    Office

    $335.74

    Facility

    $68.87

    $18.46 lower than Chico for the office setting.

  • Manhattan

    New York · 45335

    Office

    $379.81

    Facility

    $71.25

    $25.61 higher than Chico for the office setting.

  • Alaska*

    Alaska · 45335

    Office

    $361.59

    Facility

    $78.79

    $7.39 higher than Chico for the office setting.

  • Alabama

    Alabama · 45335

    Office

    $289.77

    Facility

    $57.42

    $64.43 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 45335

    Office

    $284.90

    Facility

    $56.80

    $69.30 lower than Chico for the office setting.

  • Arizona

    Arizona · 45335

    Office

    $318.35

    Facility

    $61.04

    $35.85 lower than Chico for the office setting.

  • Colorado

    Colorado · 45335

    Office

    $345.91

    Facility

    $63.38

    $8.29 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 45335

    Office

    $351.95

    Facility

    $65.97

    $2.25 lower than Chico for the office setting.

  • Delaware

    Delaware · 45335

    Office

    $324.22

    Facility

    $61.87

    $29.98 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 45335

    Office

    $335.54

    Facility

    $66.55

    $18.66 lower than Chico for the office setting.

  • Rest Of Florida

    Florida · 45335

    Office

    $317.61

    Facility

    $63.75

    $36.59 lower than Chico for the office setting.

  • Atlanta

    Georgia · 45335

    Office

    $333.67

    Facility

    $63.89

    $20.53 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 45335

    Office

    $297.62

    Facility

    $60.76

    $56.58 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 45335

    Office

    $365.70

    Facility

    $63.79

    $11.50 higher than Chico for the office setting.

  • Iowa

    Iowa · 45335

    Office

    $300.56

    Facility

    $57.60

    $53.64 lower than Chico for the office setting.

  • Idaho

    Idaho · 45335

    Office

    $302.37

    Facility

    $58.07

    $51.83 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 45335

    Office

    $309.57

    Facility

    $65.28

    $44.63 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 45335

    Office

    $305.44

    Facility

    $63.00

    $48.76 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 45335

    Office

    $339.66

    Facility

    $66.96

    $14.54 lower than Chico for the office setting.

  • Indiana

    Indiana · 45335

    Office

    $304.45

    Facility

    $58.30

    $49.75 lower than Chico for the office setting.

  • Kansas

    Kansas · 45335

    Office

    $297.88

    Facility

    $57.83

    $56.32 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 45335

    Office

    $295.46

    Facility

    $59.39

    $58.74 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 45335

    Office

    $311.55

    Facility

    $61.68

    $42.65 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 45335

    Office

    $294.50

    Facility

    $59.50

    $59.70 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 45335

    Office

    $385.05

    Facility

    $67.99

    $30.85 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45335

    Office

    $342.94

    Facility

    $63.32

    $11.26 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45335

    Office

    $350.78

    Facility

    $65.86

    $3.42 lower than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 45335

    Office

    $331.43

    Facility

    $62.70

    $22.77 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 45335

    Office

    $303.06

    Facility

    $58.77

    $51.14 lower than Chico for the office setting.

  • Southern Maine

    Maine · 45335

    Office

    $323.67

    Facility

    $60.52

    $30.53 lower than Chico for the office setting.

  • Detroit

    Michigan · 45335

    Office

    $321.07

    Facility

    $64.83

    $33.13 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 45335

    Office

    $303.41

    Facility

    $60.97

    $50.79 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 45335

    Office

    $333.10

    Facility

    $59.87

    $21.10 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 45335

    Office

    $310.22

    Facility

    $60.89

    $43.98 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 45335

    Office

    $314.11

    Facility

    $61.31

    $40.09 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 45335

    Office

    $287.91

    Facility

    $59.02

    $66.29 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 45335

    Office

    $286.52

    Facility

    $57.90

    $67.68 lower than Chico for the office setting.

  • Montana**

    Montana · 45335

    Office

    $327.99

    Facility

    $62.45

    $26.21 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 45335

    Office

    $306.91

    Facility

    $59.16

    $47.29 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 45335

    Office

    $325.22

    Facility

    $59.68

    $28.98 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 45335

    Office

    $302.79

    Facility

    $57.70

    $51.41 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 45335

    Office

    $339.29

    Facility

    $62.86

    $14.91 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 45335

    Office

    $376.77

    Facility

    $68.75

    $22.57 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 45335

    Office

    $356.44

    Facility

    $66.48

    $2.24 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 45335

    Office

    $304.90

    Facility

    $61.40

    $49.30 lower than Chico for the office setting.

  • Nevada**

    Nevada · 45335

    Office

    $327.51

    Facility

    $61.70

    $26.69 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45335

    Office

    $388.90

    Facility

    $73.17

    $34.70 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45335

    Office

    $358.01

    Facility

    $67.24

    $3.81 higher than Chico for the office setting.

  • Queens

    New York · 45335

    Office

    $384.93

    Facility

    $71.06

    $30.73 higher than Chico for the office setting.

  • Rest Of New York

    New York · 45335

    Office

    $312.13

    Facility

    $59.87

    $42.07 lower than Chico for the office setting.

  • Ohio

    Ohio · 45335

    Office

    $302.84

    Facility

    $60.40

    $51.36 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 45335

    Office

    $295.97

    Facility

    $58.84

    $58.23 lower than Chico for the office setting.

  • Portland

    Oregon · 45335

    Office

    $359.48

    Facility

    $64.47

    $5.28 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 45335

    Office

    $325.45

    Facility

    $60.97

    $28.75 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45335

    Office

    $341.38

    Facility

    $64.96

    $12.82 lower than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45335

    Office

    $303.99

    Facility

    $60.23

    $50.21 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 45335

    Office

    $331.11

    Facility

    $62.65

    $23.09 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 45335

    Office

    $337.69

    Facility

    $63.39

    $16.51 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 45335

    Office

    $305.29

    Facility

    $59.93

    $48.91 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 45335

    Office

    $324.89

    Facility

    $59.35

    $29.31 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 45335

    Office

    $299.48

    Facility

    $58.11

    $54.72 lower than Chico for the office setting.

  • Austin

    Texas · 45335

    Office

    $344.33

    Facility

    $63.39

    $9.87 lower than Chico for the office setting.

  • Beaumont

    Texas · 45335

    Office

    $301.60

    Facility

    $59.96

    $52.60 lower than Chico for the office setting.

  • Brazoria

    Texas · 45335

    Office

    $324.63

    Facility

    $61.48

    $29.57 lower than Chico for the office setting.

  • Dallas

    Texas · 45335

    Office

    $326.48

    Facility

    $62.00

    $27.72 lower than Chico for the office setting.

  • Fort Worth

    Texas · 45335

    Office

    $323.64

    Facility

    $61.82

    $30.56 lower than Chico for the office setting.

  • Galveston

    Texas · 45335

    Office

    $325.44

    Facility

    $61.76

    $28.76 lower than Chico for the office setting.

  • Houston

    Texas · 45335

    Office

    $328.00

    Facility

    $64.32

    $26.20 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 45335

    Office

    $312.77

    Facility

    $60.78

    $41.43 lower than Chico for the office setting.

  • Utah

    Utah · 45335

    Office

    $310.14

    Facility

    $60.54

    $44.06 lower than Chico for the office setting.

  • Virginia

    Virginia · 45335

    Office

    $321.70

    Facility

    $60.68

    $32.50 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45335

    Office

    $331.11

    Facility

    $62.65

    $23.09 lower than Chico for the office setting.

  • Vermont

    Vermont · 45335

    Office

    $322.79

    Facility

    $59.91

    $31.41 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 45335

    Office

    $342.67

    Facility

    $63.06

    $11.53 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 45335

    Office

    $394.56

    Facility

    $68.75

    $40.36 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 45335

    Office

    $312.60

    Facility

    $58.21

    $41.60 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 45335

    Office

    $292.08

    Facility

    $61.32

    $62.12 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 45335

    Office

    $326.78

    Facility

    $61.24

    $27.42 lower than Chico for the office setting.

See how rates vary across the country

45335 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$284.90

$405.87

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$361.591
AL$289.771
AR$284.901
AZ$318.351
CA$354.20–$457.5329
CO$345.911
CT$351.951
DC$381.891
DE$324.221
FL$317.61–$347.023
GA$297.62–$333.672
GU$365.701
HI$365.701
IA$300.561
ID$302.371
IL$305.44–$339.664
IN$304.451
KS$297.881
KY$295.461
LA$294.50–$311.552
MA$342.94–$385.052
MD$331.43–$381.893
ME$303.06–$323.672
MI$303.41–$321.072
MN$333.101
MO$287.91–$314.113
MS$286.521
MT$327.991
NC$306.911
ND$325.221
NE$302.791
NH$339.291
NJ$356.44–$376.772
NM$304.901
NV$327.511
NY$312.13–$388.905
OH$302.841
OK$295.971
OR$325.45–$359.482
PA$303.99–$341.382
PR$331.111
RI$337.691
SC$305.291
SD$324.891
TN$299.481
TX$301.60–$344.338
UT$310.141
VA$321.70–$381.892
VI$331.111
VT$322.791
WA$342.67–$394.562
WI$312.601
WV$292.081
WY$326.781

Explore 45335 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.

Why are the office and facility amounts different?

For 45335 in Chico, the physician’s office rate is $354.20 and the facility-setting rate is $63.17: a difference of $291.03.

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 45335 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$389.62

$354.20 × 110% = $389.62

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 45335 in Chico.

PPRRVU2026_Oct_nonQPP.csv

5,503

Code
45335
Physician work
1.01
Practice expense
8.67
Malpractice
0.14

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 45335 in Chico
ComponentRVULocality factorAdjusted
Physician work1.01× 1.0171.0272
Practice expense8.67× 1.0969.5023
Malpractice0.14× 0.5360.0750
Total RVUs10.6045
Conversion factor× 33.4009

Office / nonfacility rate, Chico$354.20

Open 45335 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.011.017
Practice expense8.671.096
Malpractice0.140.536

(1.01 × 1.017 + 8.67 × 1.096 + 0.14 × 0.536) × $33.4009 = $354.20

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.011.017
Practice expense0.721.096
Malpractice0.140.536

(1.01 × 1.017 + 0.72 × 1.096 + 0.14 × 0.536) × $33.4009 = $63.17

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

45335 · Office / nonfacility

$354.20

Effective 2026-10-01

The base rate is $57.33 higher than on 2025-10-01, moving from $296.87 to $354.20 (19.3%).

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

    $296.87changed to$354.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.04 changed to 1.01
    • Practice expense RVU 7.35 changed to 8.67
    • Malpractice RVU 0.16 changed to 0.14
    • 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: $296.87

    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$354.20$63.17RVU26D
2026-07-01$354.20$63.17RVU26C
2026-04-01$354.20$63.17RVU26B
2026-01-01$354.20$63.17RVU26A
2025-10-01$296.87$66.00RVU25D
2025-07-01$296.87$66.00RVU25C
2025-04-01$296.87$66.00RVU25B
2025-01-01$296.87$66.00RVU25A

45335 billing questions

When is this code appropriate instead of a diagnostic sigmoidoscopy?

Use it when the endoscopist performs a submucosal injection during the examination. A diagnostic examination without injection is reported with the diagnostic sigmoidoscopy code.

Can the diagnostic examination be billed separately?

The sigmoidoscopy is part of the service represented by this code; do not separately report a diagnostic examination for the same scope session.

What documentation supports the injection service?

Document the injection site and the substance or clinical purpose when known, along with the endoscopic findings and work performed.

Should modifier 50 be used for injections on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

How does CMS price this with another endoscopy on the same date?

When related endoscopies are performed together, CMS endoscopy family pricing applies. Same-day preoperative and postoperative care is included in this code's 0-day global period.

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 45335PPRRVU2026_Oct_nonQPP.csv, line 5,503 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)