No office rate
Both describe endoscopic decompression, but 45321 is for rigid proctosigmoidoscopy. Select 45337 when a flexible sigmoidoscope is used.
On this page
CMS RVU26D · Effective 2026-10-01
45337 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$99.60
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 45337: Flexible sigmoidoscopic decompression
Flexible sigmoidoscopy with decompression is reported when an endoscopist relieves colonic distention, commonly during endoscopic management of sigmoid volvulus.
A physician advances a flexible endoscope through the rectum into the distal colon to relieve distention, often in a patient with acute sigmoid volvulus. The endoscopist may use suction and endoscopic maneuvers to decompress the affected segment; a decompression tube may also be used when clinically indicated. Gastroenterologists and colorectal surgeons commonly perform this service in a hospital setting for an urgent obstruction-related presentation.
Report this code when the documented service includes therapeutic decompression, rather than inspection alone or another distinct intervention such as biopsy or bleeding control. The procedure note should support the indication, scope used, relevant findings, and decompression performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this service; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 45337
- 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 RVU2.05 · 69%
- Practice expense (office) RVU0.70 · 23%
- Malpractice RVU0.24 · 8%
1.8K
Medicare services in 2024 · #2561 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.
45337 compared with similar codes
Office rates for El Centro, from the same CMS release.
$231.36
45330 represents diagnostic flexible sigmoidoscopy. Choose 45337 when the procedure includes therapeutic decompression, not inspection alone.
$348.47
45331 is used when flexible sigmoidoscopy includes biopsy. Decompression, rather than tissue sampling, distinguishes 45337.
$587.11
45334 describes endoscopic control of bleeding during flexible sigmoidoscopy. Use 45337 for decompression instead.
The same code, a different location
How does El Centro compare?
45337 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
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 · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Modesto
California · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Napa
California · 45337
Office
Unavailable
Facility
$107.67
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 45337
Office
Unavailable
Facility
$103.02
No comparable office rate is available.
Redding
California · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Rest Of California
California · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 45337
Office
Unavailable
Facility
$102.17
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 45337
Office
Unavailable
Facility
$102.43
No comparable office rate is available.
Salinas
California · 45337
Office
Unavailable
Facility
$101.99
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 45337
Office
Unavailable
Facility
$102.83
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45337
Office
Unavailable
Facility
$111.62
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45337
Office
Unavailable
Facility
$111.35
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45337
Office
Unavailable
Facility
$114.02
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45337
Office
Unavailable
Facility
$112.90
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 45337
Office
Unavailable
Facility
$100.56
No comparable office rate is available.
Santa Cruz-Watsonville
California · 45337
Office
Unavailable
Facility
$102.61
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 45337
Office
Unavailable
Facility
$101.95
No comparable office rate is available.
Santa Rosa-Petaluma
California · 45337
Office
Unavailable
Facility
$103.53
No comparable office rate is available.
Stockton
California · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Vallejo
California · 45337
Office
Unavailable
Facility
$107.28
No comparable office rate is available.
Visalia
California · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Yuba City
California · 45337
Office
Unavailable
Facility
$99.56
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 45337
Office
Unavailable
Facility
$108.63
No comparable office rate is available.
Miami
Florida · 45337
Office
Unavailable
Facility
$113.08
No comparable office rate is available.
Chicago
Illinois · 45337
Office
Unavailable
Facility
$110.85
No comparable office rate is available.
Manhattan
New York · 45337
Office
Unavailable
Facility
$112.74
No comparable office rate is available.
Alaska*
Alaska · 45337
Office
Unavailable
Facility
$132.03
No comparable office rate is available.
Alabama
Alabama · 45337
Office
Unavailable
Facility
$93.47
No comparable office rate is available.
Arkansas
Arkansas · 45337
Office
Unavailable
Facility
$92.68
No comparable office rate is available.
Arizona
Arizona · 45337
Office
Unavailable
Facility
$97.99
No comparable office rate is available.
Colorado
Colorado · 45337
Office
Unavailable
Facility
$100.43
No comparable office rate is available.
Connecticut
Connecticut · 45337
Office
Unavailable
Facility
$104.72
No comparable office rate is available.
Delaware
Delaware · 45337
Office
Unavailable
Facility
$99.12
No comparable office rate is available.
Fort Lauderdale
Florida · 45337
Office
Unavailable
Facility
$106.65
No comparable office rate is available.
Rest Of Florida
Florida · 45337
Office
Unavailable
Facility
$102.87
No comparable office rate is available.
Atlanta
Georgia · 45337
Office
Unavailable
Facility
$102.06
No comparable office rate is available.
Rest Of Georgia
Georgia · 45337
Office
Unavailable
Facility
$98.88
No comparable office rate is available.
Hawaii, Guam
Hawaii · 45337
Office
Unavailable
Facility
$99.70
No comparable office rate is available.
Iowa
Iowa · 45337
Office
Unavailable
Facility
$93.05
No comparable office rate is available.
Idaho
Idaho · 45337
Office
Unavailable
Facility
$93.77
No comparable office rate is available.
East St. Louis
Illinois · 45337
Office
Unavailable
Facility
$106.13
No comparable office rate is available.
Rest Of Illinois
Illinois · 45337
Office
Unavailable
Facility
$102.35
No comparable office rate is available.
Suburban Chicago
Illinois · 45337
Office
Unavailable
Facility
$107.17
No comparable office rate is available.
Indiana
Indiana · 45337
Office
Unavailable
Facility
$94.04
No comparable office rate is available.
Kansas
Kansas · 45337
Office
Unavailable
Facility
$93.65
No comparable office rate is available.
Kentucky
Kentucky · 45337
Office
Unavailable
Facility
$96.59
No comparable office rate is available.
New Orleans
Louisiana · 45337
Office
Unavailable
Facility
$99.58
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 45337
Office
Unavailable
Facility
$96.84
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 45337
Office
Unavailable
Facility
$106.33
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 45337
Office
Unavailable
Facility
$100.58
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 45337
Office
Unavailable
Facility
$104.57
No comparable office rate is available.
Rest Of Maryland
Maryland · 45337
Office
Unavailable
Facility
$100.18
No comparable office rate is available.
Rest Of Maine
Maine · 45337
Office
Unavailable
Facility
$94.97
No comparable office rate is available.
Southern Maine
Maine · 45337
Office
Unavailable
Facility
$96.70
No comparable office rate is available.
Detroit
Michigan · 45337
Office
Unavailable
Facility
$104.55
No comparable office rate is available.
Rest Of Michigan
Michigan · 45337
Office
Unavailable
Facility
$98.87
No comparable office rate is available.
Minnesota
Minnesota · 45337
Office
Unavailable
Facility
$94.90
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 45337
Office
Unavailable
Facility
$98.26
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 45337
Office
Unavailable
Facility
$98.76
No comparable office rate is available.
Rest Of Missouri
Missouri · 45337
Office
Unavailable
Facility
$96.43
No comparable office rate is available.
Mississippi
Mississippi · 45337
Office
Unavailable
Facility
$94.53
No comparable office rate is available.
Montana**
Montana · 45337
Office
Unavailable
Facility
$99.85
No comparable office rate is available.
North Carolina
North Carolina · 45337
Office
Unavailable
Facility
$95.41
No comparable office rate is available.
North Dakota**
North Dakota · 45337
Office
Unavailable
Facility
$95.11
No comparable office rate is available.
Nebraska
Nebraska · 45337
Office
Unavailable
Facility
$93.08
No comparable office rate is available.
New Hampshire
New Hampshire · 45337
Office
Unavailable
Facility
$99.83
No comparable office rate is available.
Northern Nj
New Jersey · 45337
Office
Unavailable
Facility
$108.47
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 45337
Office
Unavailable
Facility
$105.54
No comparable office rate is available.
New Mexico
New Mexico · 45337
Office
Unavailable
Facility
$99.54
No comparable office rate is available.
Nevada**
Nevada · 45337
Office
Unavailable
Facility
$98.55
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 45337
Office
Unavailable
Facility
$115.54
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 45337
Office
Unavailable
Facility
$106.85
No comparable office rate is available.
Queens
New York · 45337
Office
Unavailable
Facility
$112.05
No comparable office rate is available.
Rest Of New York
New York · 45337
Office
Unavailable
Facility
$96.32
No comparable office rate is available.
Ohio
Ohio · 45337
Office
Unavailable
Facility
$97.90
No comparable office rate is available.
Oklahoma
Oklahoma · 45337
Office
Unavailable
Facility
$95.58
No comparable office rate is available.
Portland
Oregon · 45337
Office
Unavailable
Facility
$101.51
No comparable office rate is available.
Rest Of Oregon
Oregon · 45337
Office
Unavailable
Facility
$97.39
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 45337
Office
Unavailable
Facility
$103.61
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 45337
Office
Unavailable
Facility
$97.51
No comparable office rate is available.
Puerto Rico
Puerto Rico · 45337
Office
Unavailable
Facility
$100.01
No comparable office rate is available.
Rhode Island
Rhode Island · 45337
Office
Unavailable
Facility
$101.08
No comparable office rate is available.
South Carolina
South Carolina · 45337
Office
Unavailable
Facility
$96.89
No comparable office rate is available.
South Dakota**
South Dakota · 45337
Office
Unavailable
Facility
$94.55
No comparable office rate is available.
Tennessee
Tennessee · 45337
Office
Unavailable
Facility
$94.03
No comparable office rate is available.
Austin
Texas · 45337
Office
Unavailable
Facility
$100.45
No comparable office rate is available.
Beaumont
Texas · 45337
Office
Unavailable
Facility
$97.20
No comparable office rate is available.
Brazoria
Texas · 45337
Office
Unavailable
Facility
$98.44
No comparable office rate is available.
Dallas
Texas · 45337
Office
Unavailable
Facility
$99.25
No comparable office rate is available.
Fort Worth
Texas · 45337
Office
Unavailable
Facility
$99.12
No comparable office rate is available.
Galveston
Texas · 45337
Office
Unavailable
Facility
$98.87
No comparable office rate is available.
Houston
Texas · 45337
Office
Unavailable
Facility
$103.27
No comparable office rate is available.
Rest Of Texas
Texas · 45337
Office
Unavailable
Facility
$97.90
No comparable office rate is available.
Utah
Utah · 45337
Office
Unavailable
Facility
$97.65
No comparable office rate is available.
Virginia
Virginia · 45337
Office
Unavailable
Facility
$97.11
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 45337
Office
Unavailable
Facility
$100.01
No comparable office rate is available.
Vermont
Vermont · 45337
Office
Unavailable
Facility
$95.67
No comparable office rate is available.
Rest Of Washington
Washington · 45337
Office
Unavailable
Facility
$100.08
No comparable office rate is available.
Seattle (King Cnty)
Washington · 45337
Office
Unavailable
Facility
$107.13
No comparable office rate is available.
Wisconsin
Wisconsin · 45337
Office
Unavailable
Facility
$93.34
No comparable office rate is available.
West Virginia
West Virginia · 45337
Office
Unavailable
Facility
$100.26
No comparable office rate is available.
Wyoming**
Wyoming · 45337
Office
Unavailable
Facility
$97.78
No comparable office rate is available.
See how rates vary across the country
45337 · 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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 45337 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$109.56
$99.60 × 110% = $109.56
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.
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 45337 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
5,504
- Code
- 45337
- Physician work
- 2.05
- Practice expense
- 0.70
- Malpractice
- 0.24
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.05 | × 1.017 | 2.0848 |
| Practice expense | 0.70 | × 1.096 | 0.7672 |
| Malpractice | 0.24 | × 0.541 | 0.1298 |
| Total RVUs | 2.9819 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$99.60
Open 45337 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.05 | 1.017 |
| Practice expense | 0.7 | 1.096 |
| Malpractice | 0.24 | 0.541 |
(2.05 × 1.017 + 0.7 × 1.096 + 0.24 × 0.541) × $33.4009 = $99.60
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
45337 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $99.60 | RVU26D |
| 2026-07-01 | Not available in this setting | $99.60 | RVU26C |
| 2026-04-01 | Not available in this setting | $99.60 | RVU26B |
| 2026-01-01 | Not available in this setting | $99.60 | RVU26A |
| 2025-10-01 | Not available in this setting | $109.92 | RVU25D |
| 2025-07-01 | Not available in this setting | $109.92 | RVU25C |
| 2025-04-01 | Not available in this setting | $109.92 | RVU25B |
| 2025-01-01 | Not available in this setting | $109.92 | RVU25A |
45337 billing questions
Can a biopsy or bleeding-control service be reported in the same session?
A separately performed intervention must be supported by the procedure documentation. When related endoscopies are performed together, CMS endoscopy-family pricing applies.
Can modifier 50 be appended?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
Is assistant-at-surgery payment available?
No. CMS applies a statutory restriction to assistant-at-surgery payment for this code; co-surgeons and team surgery are also not permitted.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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.
5,50145333,,Sigmoidoscopy & polypectomy,A,,1.51,9.29,,0.86,,0.22,11.02,2.59,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50245334,,Sigmoidoscopy for bleeding,A,,1.95,14.12,,1.00,,0.22,16.29,3.17,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50345335,,Sigmoidoscopy w/submuc inj,A,,1.01,8.67,,0.72,,0.14,9.82,1.87,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50445337,,Sigmoidoscopy & decompress,A,,2.05,0.70,NA,0.70,,0.24,2.99,2.99,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50545338,,Sigmoidoscopy w/tumr remove,A,,2.00,7.78,,1.01,,0.25,10.03,3.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50645340,,Sig w/tndsc balloon dilation,A,,1.22,13.80,,0.78,,0.17,15.19,2.17,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50745341,,Sigmoidoscopy w/ultrasound,A,,2.07,1.04,NA,1.04,,0.23,3.34,3.34,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664