$395.35
45333 is for lesion removal using hot biopsy forceps or bipolar cautery. Choose 45346 when the lesion is ablated rather than removed and is not amenable to those methods.
On this page
CMS RVU26D · Effective 2026-10-01
45346 in El Centro
Office / nonfacility
$2718.11
Base rate per service
Facility setting
$143.51
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.
Endoscopy
About 45346: Flexible sigmoidoscopy with lesion ablation
Reports flexible sigmoidoscopy treatment that ablates a colorectal tumor, polyp, or other lesion that is not suited to standard endoscopic removal.
During flexible sigmoidoscopy, the clinician examines the rectum and sigmoid colon and destroys a tumor, polyp, or other lesion endoscopically, such as with laser or electrosurgical energy. This treatment is selected when the lesion is not amenable to removal with hot biopsy forceps, bipolar cautery, or a snare. Gastroenterologists and colorectal surgeons commonly perform it in an endoscopy unit or procedure room.
Report the service when the operative note supports ablation rather than biopsy, snare removal, or another therapeutic technique. Document the lesion treated, its location, the ablation method, and why the chosen approach was used. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Do not append modifier 50; this flexible endoscopic treatment is not a bilateral procedure. CMS does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 45346
- 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 RVU2.74 · 4%
- Practice expense (office) RVU71.54 · 96%
- Malpractice RVU0.34 · 0%
984
Medicare services in 2024 · #2982 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.
45346 compared with similar codes
Office rates for El Centro, from the same CMS release.
$357.26
45338 reports lesion removal by snare. Choose 45346 when the treatment is ablation, not snare excision.
$231.36
45330 is diagnostic flexible sigmoidoscopy without lesion ablation. When ablation is performed, the therapeutic service distinguishes 45346.
No office rate
45349 reports endoscopic mucosal resection. It differs from 45346, which describes ablation of a lesion rather than mucosal resection.
The same code, a different location
How does El Centro compare?
In Bakersfield, the office rate for 45346 is $2719.07—$0.96 higher than the $2718.11 rate in El Centro. Both use the same code, release and participation basis.
45346 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
$2718.11
$2719.07
$0.96 higher than El Centro
$2718.05
$0.06 lower than El Centro
$2718.05
$0.06 lower than El Centro
$2718.05
$0.06 lower than El Centro
$211.48 higher than El Centro
$2718.05
$0.06 lower than El Centro
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, 45346 ranges from $2149.95 in Arkansas to $3553.33 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 · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Modesto
California · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Napa
California · 45346
Office
$3252.41
Facility
$156.32
$534.30 higher than El Centro for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 45346
Office
$2925.55
Facility
$148.93
$207.44 higher than El Centro for the office setting.
Redding
California · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Rest Of California
California · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Riverside-San Bernardino-Ontario
California · 45346
Office
$2721.75
Facility
$147.15
$3.64 higher than El Centro for the office setting.
Sacramento-Roseville-Folsom
California · 45346
Office
$2879.89
Facility
$147.90
$161.78 higher than El Centro for the office setting.
Salinas
California · 45346
Office
$2869.87
Facility
$147.28
$151.76 higher than El Centro for the office setting.
San Diego-Chula Vista-Carlsbad
California · 45346
Office
$2958.26
Facility
$148.76
$240.15 higher than El Centro for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45346
Office
$3474.62
Facility
$162.41
$756.51 higher than El Centro for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45346
Office
$3474.23
Facility
$162.02
$756.12 higher than El Centro for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45346
Office
$3553.33
Facility
$165.95
$835.22 higher than El Centro for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45346
Office
$3551.75
Facility
$164.37
$833.64 higher than El Centro for the office setting.
San Luis Obispo-Paso Robles
California · 45346
Office
$2820.80
Facility
$145.19
$102.69 higher than El Centro for the office setting.
Santa Cruz-Watsonville
California · 45346
Office
$3002.77
Facility
$148.63
$284.66 higher than El Centro for the office setting.
Santa Maria-Santa Barbara
California · 45346
Office
$2886.33
Facility
$147.29
$168.22 higher than El Centro for the office setting.
Santa Rosa-Petaluma
California · 45346
Office
$3034.66
Facility
$149.98
$316.55 higher than El Centro for the office setting.
Stockton
California · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Vallejo
California · 45346
Office
$3251.86
Facility
$155.76
$533.75 higher than El Centro for the office setting.
Visalia
California · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Yuba City
California · 45346
Office
$2718.05
Facility
$143.46
$0.06 lower than El Centro for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 45346
Office
$2923.93
Facility
$156.71
$205.82 higher than El Centro for the office setting.
Miami
Florida · 45346
Office
$2607.71
Facility
$162.31
$110.40 lower than El Centro for the office setting.
Chicago
Illinois · 45346
Office
$2519.67
Facility
$158.84
$198.44 lower than El Centro for the office setting.
Manhattan
New York · 45346
Office
$2891.99
Facility
$162.35
$173.88 higher than El Centro for the office setting.
Alaska*
Alaska · 45346
Office
$2688.35
Facility
$186.58
$29.76 lower than El Centro for the office setting.
Alabama
Alabama · 45346
Office
$2188.76
Facility
$133.31
$529.35 lower than El Centro for the office setting.
Arkansas
Arkansas · 45346
Office
$2149.95
Facility
$132.08
$568.16 lower than El Centro for the office setting.
Arizona
Arizona · 45346
Office
$2416.67
Facility
$140.40
$301.44 lower than El Centro for the office setting.
Colorado
Colorado · 45346
Office
$2643.91
Facility
$144.49
$74.20 lower than El Centro for the office setting.
Connecticut
Connecticut · 45346
Office
$2680.58
Facility
$150.62
$37.53 lower than El Centro for the office setting.
Delaware
Delaware · 45346
Office
$2463.01
Facility
$142.12
$255.10 lower than El Centro for the office setting.
Fort Lauderdale
Florida · 45346
Office
$2532.61
Facility
$152.99
$185.50 lower than El Centro for the office setting.
Rest Of Florida
Florida · 45346
Office
$2392.95
Facility
$147.22
$325.16 lower than El Centro for the office setting.
Atlanta
Georgia · 45346
Office
$2533.16
Facility
$146.49
$184.95 lower than El Centro for the office setting.
Rest Of Georgia
Georgia · 45346
Office
$2236.49
Facility
$141.11
$481.62 lower than El Centro for the office setting.
Hawaii, Guam
Hawaii · 45346
Office
$2814.96
Facility
$144.05
$96.85 higher than El Centro for the office setting.
Iowa
Iowa · 45346
Office
$2282.42
Facility
$133.01
$435.69 lower than El Centro for the office setting.
Idaho
Idaho · 45346
Office
$2295.23
Facility
$134.07
$422.88 lower than El Centro for the office setting.
East St. Louis
Illinois · 45346
Office
$2312.73
Facility
$151.57
$405.38 lower than El Centro for the office setting.
Rest Of Illinois
Illinois · 45346
Office
$2290.88
Facility
$146.17
$427.23 lower than El Centro for the office setting.
Suburban Chicago
Illinois · 45346
Office
$2566.30
Facility
$153.79
$151.81 lower than El Centro for the office setting.
Indiana
Indiana · 45346
Office
$2312.10
Facility
$134.50
$406.01 lower than El Centro for the office setting.
Kansas
Kansas · 45346
Office
$2257.35
Facility
$133.78
$460.76 lower than El Centro for the office setting.
Kentucky
Kentucky · 45346
Office
$2226.18
Facility
$137.84
$491.93 lower than El Centro for the office setting.
New Orleans
Louisiana · 45346
Office
$2352.94
Facility
$142.45
$365.17 lower than El Centro for the office setting.
Rest Of Louisiana
Louisiana · 45346
Office
$2217.11
Facility
$138.17
$501.00 lower than El Centro for the office setting.
Metropolitan Boston
Massachusetts · 45346
Office
$2958.44
Facility
$153.63
$240.33 higher than El Centro for the office setting.
Rest Of Massachusetts
Massachusetts · 45346
Office
$2618.18
Facility
$144.59
$99.93 lower than El Centro for the office setting.
Baltimore/Surr. Cntys
Maryland · 45346
Office
$2670.96
Facility
$150.40
$47.15 lower than El Centro for the office setting.
Rest Of Maryland
Maryland · 45346
Office
$2521.03
Facility
$143.76
$197.08 lower than El Centro for the office setting.
Rest Of Maine
Maine · 45346
Office
$2296.92
Facility
$135.76
$421.19 lower than El Centro for the office setting.
Southern Maine
Maine · 45346
Office
$2466.68
Facility
$138.74
$251.43 lower than El Centro for the office setting.
Detroit
Michigan · 45346
Office
$2416.53
Facility
$149.67
$301.58 lower than El Centro for the office setting.
Rest Of Michigan
Michigan · 45346
Office
$2285.95
Facility
$141.24
$432.16 lower than El Centro for the office setting.
Minnesota
Minnesota · 45346
Office
$2553.68
Facility
$136.47
$164.43 lower than El Centro for the office setting.
Metropolitan Kansas City
Missouri · 45346
Office
$2346.35
Facility
$140.56
$371.76 lower than El Centro for the office setting.
Metropolitan St. Louis
Missouri · 45346
Office
$2377.70
Facility
$141.37
$340.41 lower than El Centro for the office setting.
Rest Of Missouri
Missouri · 45346
Office
$2162.33
Facility
$137.42
$555.78 lower than El Centro for the office setting.
Mississippi
Mississippi · 45346
Office
$2157.27
Facility
$134.71
$560.84 lower than El Centro for the office setting.
Montana**
Montana · 45346
Office
$2492.35
Facility
$143.27
$225.76 lower than El Centro for the office setting.
North Carolina
North Carolina · 45346
Office
$2328.18
Facility
$136.48
$389.93 lower than El Centro for the office setting.
North Dakota**
North Dakota · 45346
Office
$2485.63
Facility
$136.54
$232.48 lower than El Centro for the office setting.
Nebraska
Nebraska · 45346
Office
$2301.32
Facility
$133.11
$416.79 lower than El Centro for the office setting.
New Hampshire
New Hampshire · 45346
Office
$2588.93
Facility
$143.53
$129.18 lower than El Centro for the office setting.
Northern Nj
New Jersey · 45346
Office
$2881.23
Facility
$156.29
$163.12 higher than El Centro for the office setting.
Rest Of New Jersey
New Jersey · 45346
Office
$2716.97
Facility
$151.77
$1.14 lower than El Centro for the office setting.
New Mexico
New Mexico · 45346
Office
$2296.33
Facility
$142.22
$421.78 lower than El Centro for the office setting.
Nevada**
Nevada · 45346
Office
$2492.87
Facility
$141.43
$225.24 lower than El Centro for the office setting.
Nyc Suburbs/Long Island
New York · 45346
Office
$2959.58
Facility
$166.52
$241.47 higher than El Centro for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 45346
Office
$2725.88
Facility
$153.63
$7.77 higher than El Centro for the office setting.
Queens
New York · 45346
Office
$2938.14
Facility
$161.52
$220.03 higher than El Centro for the office setting.
Rest Of New York
New York · 45346
Office
$2369.53
Facility
$137.90
$348.58 lower than El Centro for the office setting.
Ohio
Ohio · 45346
Office
$2284.58
Facility
$139.86
$433.53 lower than El Centro for the office setting.
Oklahoma
Oklahoma · 45346
Office
$2234.17
Facility
$136.43
$483.94 lower than El Centro for the office setting.
Portland
Oregon · 45346
Office
$2756.17
Facility
$146.33
$38.06 higher than El Centro for the office setting.
Rest Of Oregon
Oregon · 45346
Office
$2479.44
Facility
$139.76
$238.67 lower than El Centro for the office setting.
Metropolitan Philadelphia
Pennsylvania · 45346
Office
$2594.18
Facility
$148.79
$123.93 lower than El Centro for the office setting.
Rest Of Pennsylvania
Pennsylvania · 45346
Office
$2295.81
Facility
$139.35
$422.30 lower than El Centro for the office setting.
Puerto Rico
Puerto Rico · 45346
Office
$2518.49
Facility
$143.56
$199.62 lower than El Centro for the office setting.
Rhode Island
Rhode Island · 45346
Office
$2571.74
Facility
$145.14
$146.37 lower than El Centro for the office setting.
South Carolina
South Carolina · 45346
Office
$2309.07
Facility
$138.51
$409.04 lower than El Centro for the office setting.
South Dakota**
South Dakota · 45346
Office
$2484.83
Facility
$135.75
$233.28 lower than El Centro for the office setting.
Tennessee
Tennessee · 45346
Office
$2269.67
Facility
$134.35
$448.44 lower than El Centro for the office setting.
Austin
Texas · 45346
Office
$2629.85
Facility
$144.52
$88.26 lower than El Centro for the office setting.
Beaumont
Texas · 45346
Office
$2276.51
Facility
$138.85
$441.60 lower than El Centro for the office setting.
Brazoria
Texas · 45346
Office
$2469.10
Facility
$141.16
$249.01 lower than El Centro for the office setting.
Dallas
Texas · 45346
Office
$2482.03
Facility
$142.34
$236.08 lower than El Centro for the office setting.
Fort Worth
Texas · 45346
Office
$2458.28
Facility
$142.08
$259.83 lower than El Centro for the office setting.
Galveston
Texas · 45346
Office
$2474.43
Facility
$141.79
$243.68 lower than El Centro for the office setting.
Houston
Texas · 45346
Office
$2480.65
Facility
$148.01
$237.46 lower than El Centro for the office setting.
Rest Of Texas
Texas · 45346
Office
$2369.41
Facility
$140.13
$348.70 lower than El Centro for the office setting.
Utah
Utah · 45346
Office
$2347.85
Facility
$139.71
$370.26 lower than El Centro for the office setting.
Virginia
Virginia · 45346
Office
$2448.41
Facility
$139.26
$269.70 lower than El Centro for the office setting.
Virgin Islands
United States Virgin Islands · 45346
Office
$2518.49
Facility
$143.56
$199.62 lower than El Centro for the office setting.
Vermont
Vermont · 45346
Office
$2462.87
Facility
$137.28
$255.24 lower than El Centro for the office setting.
Rest Of Washington
Washington · 45346
Office
$2617.49
Facility
$143.91
$100.62 lower than El Centro for the office setting.
Seattle (King Cnty)
Washington · 45346
Office
$3037.29
Facility
$154.96
$319.18 higher than El Centro for the office setting.
Wisconsin
Wisconsin · 45346
Office
$2384.16
Facility
$133.73
$333.95 lower than El Centro for the office setting.
West Virginia
West Virginia · 45346
Office
$2184.25
Facility
$142.89
$533.86 lower than El Centro for the office setting.
Wyoming**
Wyoming · 45346
Office
$2489.42
Facility
$140.34
$228.69 lower than El Centro for the office setting.
See how rates vary across the country
45346 · 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.
$2,149.95
$3,135.69
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $2,688.35 | 1 |
| AL | $2,188.76 | 1 |
| AR | $2,149.95 | 1 |
| AZ | $2,416.67 | 1 |
| CA | $2,718.05–$3,553.33 | 29 |
| CO | $2,643.91 | 1 |
| CT | $2,680.58 | 1 |
| DC | $2,923.93 | 1 |
| DE | $2,463.01 | 1 |
| FL | $2,392.95–$2,607.71 | 3 |
| GA | $2,236.49–$2,533.16 | 2 |
| GU | $2,814.96 | 1 |
| HI | $2,814.96 | 1 |
| IA | $2,282.42 | 1 |
| ID | $2,295.23 | 1 |
| IL | $2,290.88–$2,566.30 | 4 |
| IN | $2,312.10 | 1 |
| KS | $2,257.35 | 1 |
| KY | $2,226.18 | 1 |
| LA | $2,217.11–$2,352.94 | 2 |
| MA | $2,618.18–$2,958.44 | 2 |
| MD | $2,521.03–$2,923.93 | 3 |
| ME | $2,296.92–$2,466.68 | 2 |
| MI | $2,285.95–$2,416.53 | 2 |
| MN | $2,553.68 | 1 |
| MO | $2,162.33–$2,377.70 | 3 |
| MS | $2,157.27 | 1 |
| MT | $2,492.35 | 1 |
| NC | $2,328.18 | 1 |
| ND | $2,485.63 | 1 |
| NE | $2,301.32 | 1 |
| NH | $2,588.93 | 1 |
| NJ | $2,716.97–$2,881.23 | 2 |
| NM | $2,296.33 | 1 |
| NV | $2,492.87 | 1 |
| NY | $2,369.53–$2,959.58 | 5 |
| OH | $2,284.58 | 1 |
| OK | $2,234.17 | 1 |
| OR | $2,479.44–$2,756.17 | 2 |
| PA | $2,295.81–$2,594.18 | 2 |
| PR | $2,518.49 | 1 |
| RI | $2,571.74 | 1 |
| SC | $2,309.07 | 1 |
| SD | $2,484.83 | 1 |
| TN | $2,269.67 | 1 |
| TX | $2,276.51–$2,629.85 | 8 |
| UT | $2,347.85 | 1 |
| VA | $2,448.41–$2,923.93 | 2 |
| VI | $2,518.49 | 1 |
| VT | $2,462.87 | 1 |
| WA | $2,617.49–$3,037.29 | 2 |
| WI | $2,384.16 | 1 |
| WV | $2,184.25 | 1 |
| WY | $2,489.42 | 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.
Why are the office and facility amounts different?
For 45346 in El Centro, the physician’s office rate is $2718.11 and the facility-setting rate is $143.51: a difference of $2574.60.
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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 45346 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2989.92
$2718.11 × 110% = $2989.92
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 45346 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
5,509
- Code
- 45346
- Physician work
- 2.74
- Practice expense
- 71.54
- Malpractice
- 0.34
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.74 | × 1.017 | 2.7866 |
| Practice expense | 71.54 | × 1.096 | 78.4078 |
| Malpractice | 0.34 | × 0.541 | 0.1839 |
| Total RVUs | 81.3784 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, El Centro$2718.11
Open 45346 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.74 | 1.017 |
| Practice expense | 71.54 | 1.096 |
| Malpractice | 0.34 | 0.541 |
(2.74 × 1.017 + 71.54 × 1.096 + 0.34 × 0.541) × $33.4009 = $2718.11
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.74 | 1.017 |
| Practice expense | 1.21 | 1.096 |
| Malpractice | 0.34 | 0.541 |
(2.74 × 1.017 + 1.21 × 1.096 + 0.34 × 0.541) × $33.4009 = $143.51
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
45346 · Office / nonfacility
$2718.11
Effective 2026-10-01
The base rate is $454.37 higher than on 2025-10-01, moving from $2263.74 to $2718.11 (20.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$2263.74changed to$2718.11
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.81 changed to 2.74
- Practice expense RVU 61.24 changed to 71.54
- Malpractice RVU 0.35 changed to 0.34
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.570 changed to 0.541
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $2263.74
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $2718.11 | $143.51 | RVU26D |
| 2026-07-01 | $2718.11 | $143.51 | RVU26C |
| 2026-04-01 | $2718.11 | $143.51 | RVU26B |
| 2026-01-01 | $2718.11 | $143.51 | RVU26A |
| 2025-10-01 | $2263.74 | $154.83 | RVU25D |
| 2025-07-01 | $2263.74 | $154.83 | RVU25C |
| 2025-04-01 | $2263.74 | $154.83 | RVU25B |
| 2025-01-01 | $2263.74 | $154.83 | RVU25A |
45346 billing questions
When should this code be chosen instead of a removal code?
Use it when the lesion is ablated rather than removed and is not amenable to hot biopsy forceps, bipolar cautery, or snare removal. The operative note should identify the technique and lesion.
How does this differ from diagnostic flexible sigmoidoscopy?
A diagnostic examination reports the inspection when no ablation is performed. When a lesion is treated by ablation during the examination, report the therapeutic service instead of treating the encounter as diagnostic only.
Can biopsy or another endoscopy be reported on the same date?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Documentation should distinguish any separately performed service; do not report a diagnostic examination merely for the inspection integral to the therapeutic procedure.
Should modifier 50 be appended?
No. This is not a bilateral procedure, so modifier 50 is inappropriate.
What global-period and surgical-assistance rules apply?
The service has a 0-day global period, with same-day preoperative and postoperative care included. CMS does not pay an assistant at surgery, and 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.
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
5,50845342,,Sigmoidoscopy w/us guide bx,A,,2.91,1.27,NA,1.27,,0.36,4.54,4.54,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50945346,,Sigmoidoscopy w/ablation,A,,2.74,71.54,,1.21,,0.34,74.62,4.29,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,51045347,,Sigmoidoscopy w/plcmt stent,A,,2.65,1.14,NA,1.14,,0.30,4.09,4.09,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,51145349,,Sigmoidoscopy w/resection,A,,3.43,1.43,NA,1.43,,0.39,5.25,5.25,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,51245350,,Sgmdsc w/band ligation,A,,1.64,20.41,,0.90,,0.21,22.26,2.75,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
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