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CMS RVU26D · Effective 2026-10-01

45315 in Merced

Office / nonfacility

$262.86

Base rate per service

Facility setting

$97.40

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Lower GI endoscopy

About 45315: Rigid proctosigmoidoscopy with snare lesion removal

Report this service when a clinician uses a rigid proctosigmoidoscope to remove a rectal or distal sigmoid polyp or other lesion with a snare.

This procedure combines examination through a rigid proctosigmoidoscope with snare removal of a lesion in the rectum or distal sigmoid colon. A colorectal surgeon or gastroenterologist may perform it when a polyp can be reached through the rigid instrument. The procedure may take place in an office or outpatient facility, depending on the patient and setting.

Select this code from the operative note’s scope type, lesion location, and removal technique; a flexible sigmoidoscope or biopsy alone points to a different code. The diagnostic examination inherent in the removal is included. When related endoscopies are performed together, CMS applies endoscopy family pricing rather than simply adding their full payments. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this anatomy. CMS does not pay an assistant at surgery for this code and does not permit co-surgeons or team surgery.

CMS billing rules for 45315

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 RVU1.66 · 22%
  • Practice expense (office) RVU5.43 · 72%
  • Malpractice RVU0.43 · 6%

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.

45315 compared with similar codes

Office rates for Merced, from the same CMS release.

45338

Flexible sigmoidoscopy

Snare lesion removal

$357.22

Both involve snare removal, but 45315 uses a rigid proctosigmoidoscope; 45338 uses a flexible sigmoidoscope.

45305

Proctosigmoidoscopy

Rigid scope with biopsy

$210.75

Choose 45305 for a biopsy through a rigid proctosigmoidoscope, rather than removal of a lesion with a snare.

45300

Proctosigmoidoscopy

Rigid, diagnostic

$158.41

45300 represents the diagnostic rigid examination. Use 45315 when that examination includes documented snare removal.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 45315 is $264.02—$1.16 higher than the $262.86 rate in Merced. Both use the same code, release and participation basis.

45315 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $262.86

  2. Bakersfield

    $264.02

    $1.16 higher than Merced

  3. Chico

    $262.86

    The same base rate than Merced

  4. El Centro

    $262.94

    $0.08 higher than Merced

  5. Fresno

    $262.86

    The same base rate than Merced

  6. Hanford-Corcoran

    $262.86

    The same base rate than Merced

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

    $281.81

    $18.95 higher than Merced

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, 45315 ranges from $218.64 in Arkansas to $330.77 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

  • Madera

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Modesto

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Napa

    California · 45315

    Office

    $305.28

    Facility

    $106.30

    $42.42 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45315

    Office

    $280.32

    Facility

    $101.87

    $17.46 higher than Merced for the office setting.

  • Redding

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45315

    Office

    $267.47

    Facility

    $102.01

    $4.61 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45315

    Office

    $276.07

    Facility

    $100.49

    $13.21 higher than Merced for the office setting.

  • Salinas

    California · 45315

    Office

    $275.07

    Facility

    $100.09

    $12.21 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45315

    Office

    $281.81

    Facility

    $101.25

    $18.95 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45315

    Office

    $323.03

    Facility

    $110.16

    $60.17 higher than Merced for the office setting.

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

    California · 45315

    Office

    $322.54

    Facility

    $109.67

    $59.68 higher than Merced for the office setting.

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

    California · 45315

    Office

    $330.77

    Facility

    $113.07

    $67.91 higher than Merced for the office setting.

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

    California · 45315

    Office

    $328.78

    Facility

    $111.08

    $65.92 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45315

    Office

    $270.66

    Facility

    $98.71

    $7.80 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 45315

    Office

    $284.67

    Facility

    $101.24

    $21.81 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 45315

    Office

    $276.17

    Facility

    $100.14

    $13.31 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 45315

    Office

    $287.53

    Facility

    $102.13

    $24.67 higher than Merced for the office setting.

  • Stockton

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 45315

    Office

    $304.57

    Facility

    $105.59

    $41.71 higher than Merced for the office setting.

  • Visalia

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 45315

    Office

    $262.86

    Facility

    $97.40

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45315

    Office

    $288.08

    Facility

    $110.23

    $25.22 higher than Merced for the office setting.

  • Miami

    Florida · 45315

    Office

    $280.57

    Facility

    $123.41

    $17.71 higher than Merced for the office setting.

  • Chicago

    Illinois · 45315

    Office

    $271.07

    Facility

    $119.34

    $8.21 higher than Merced for the office setting.

  • Manhattan

    New York · 45315

    Office

    $292.52

    Facility

    $117.09

    $29.66 higher than Merced for the office setting.

  • Alaska*

    Alaska · 45315

    Office

    $284.24

    Facility

    $123.45

    $21.38 higher than Merced for the office setting.

  • Alabama

    Alabama · 45315

    Office

    $222.27

    Facility

    $90.17

    $40.59 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 45315

    Office

    $218.64

    Facility

    $88.95

    $44.22 lower than Merced for the office setting.

  • Arizona

    Arizona · 45315

    Office

    $243.48

    Facility

    $97.19

    $19.38 lower than Merced for the office setting.

  • Colorado

    Colorado · 45315

    Office

    $260.30

    Facility

    $99.67

    $2.56 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 45315

    Office

    $269.27

    Facility

    $106.67

    $6.41 higher than Merced for the office setting.

  • Delaware

    Delaware · 45315

    Office

    $247.82

    Facility

    $98.66

    $15.04 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 45315

    Office

    $265.14

    Facility

    $112.20

    $2.28 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 45315

    Office

    $250.42

    Facility

    $106.09

    $12.44 lower than Merced for the office setting.

  • Atlanta

    Georgia · 45315

    Office

    $257.13

    Facility

    $103.74

    $5.73 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 45315

    Office

    $234.34

    Facility

    $99.68

    $28.52 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 45315

    Office

    $269.98

    Facility

    $98.32

    $7.12 higher than Merced for the office setting.

  • Iowa

    Iowa · 45315

    Office

    $227.10

    Facility

    $88.96

    $35.76 lower than Merced for the office setting.

  • Idaho

    Idaho · 45315

    Office

    $229.10

    Facility

    $90.20

    $33.76 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 45315

    Office

    $251.23

    Facility

    $112.33

    $11.63 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 45315

    Office

    $243.48

    Facility

    $105.64

    $19.38 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 45315

    Office

    $267.55

    Facility

    $112.50

    $4.69 higher than Merced for the office setting.

  • Indiana

    Indiana · 45315

    Office

    $230.55

    Facility

    $90.60

    $32.31 lower than Merced for the office setting.

  • Kansas

    Kansas · 45315

    Office

    $226.64

    Facility

    $90.16

    $36.22 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 45315

    Office

    $229.82

    Facility

    $95.61

    $33.04 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 45315

    Office

    $242.43

    Facility

    $100.36

    $20.43 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 45315

    Office

    $229.71

    Facility

    $96.10

    $33.15 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 45315

    Office

    $287.05

    Facility

    $106.79

    $24.19 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45315

    Office

    $258.76

    Facility

    $99.79

    $4.10 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45315

    Office

    $268.71

    Facility

    $106.71

    $5.85 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 45315

    Office

    $252.73

    Facility

    $99.94

    $10.13 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 45315

    Office

    $231.24

    Facility

    $92.34

    $31.62 lower than Merced for the office setting.

  • Southern Maine

    Maine · 45315

    Office

    $244.24

    Facility

    $94.63

    $18.62 lower than Merced for the office setting.

  • Detroit

    Michigan · 45315

    Office

    $254.68

    Facility

    $108.99

    $8.18 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 45315

    Office

    $237.25

    Facility

    $99.41

    $25.61 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 45315

    Office

    $246.32

    Facility

    $90.97

    $16.54 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 45315

    Office

    $239.78

    Facility

    $98.02

    $23.08 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 45315

    Office

    $242.50

    Facility

    $98.77

    $20.36 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 45315

    Office

    $225.77

    Facility

    $95.63

    $37.09 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 45315

    Office

    $222.22

    Facility

    $92.23

    $40.64 lower than Merced for the office setting.

  • Montana**

    Montana · 45315

    Office

    $251.15

    Facility

    $100.17

    $11.71 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 45315

    Office

    $233.84

    Facility

    $92.98

    $29.02 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 45315

    Office

    $242.64

    Facility

    $91.67

    $20.22 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 45315

    Office

    $228.28

    Facility

    $88.93

    $34.58 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 45315

    Office

    $256.82

    Facility

    $99.65

    $6.04 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 45315

    Office

    $284.66

    Facility

    $109.54

    $21.80 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 45315

    Office

    $271.47

    Facility

    $106.61

    $8.61 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 45315

    Office

    $239.01

    Facility

    $100.57

    $23.85 lower than Merced for the office setting.

  • Nevada**

    Nevada · 45315

    Office

    $248.96

    Facility

    $97.83

    $13.90 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45315

    Office

    $301.31

    Facility

    $121.80

    $38.45 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45315

    Office

    $273.92

    Facility

    $108.60

    $11.06 higher than Merced for the office setting.

  • Queens

    New York · 45315

    Office

    $294.08

    Facility

    $115.63

    $31.22 higher than Merced for the office setting.

  • Rest Of New York

    New York · 45315

    Office

    $237.84

    Facility

    $94.42

    $25.02 lower than Merced for the office setting.

  • Ohio

    Ohio · 45315

    Office

    $235.51

    Facility

    $97.67

    $27.35 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 45315

    Office

    $228.57

    Facility

    $93.75

    $34.29 lower than Merced for the office setting.

  • Portland

    Oregon · 45315

    Office

    $268.52

    Facility

    $100.79

    $5.66 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 45315

    Office

    $246.18

    Facility

    $95.82

    $16.68 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45315

    Office

    $262.38

    Facility

    $105.22

    $0.48 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45315

    Office

    $235.51

    Facility

    $96.92

    $27.35 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 45315

    Office

    $252.95

    Facility

    $100.32

    $9.91 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 45315

    Office

    $256.66

    Facility

    $100.71

    $6.20 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 45315

    Office

    $235.24

    Facility

    $95.74

    $27.62 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 45315

    Office

    $241.64

    Facility

    $90.67

    $21.22 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 45315

    Office

    $228.02

    Facility

    $90.79

    $34.84 lower than Merced for the office setting.

  • Austin

    Texas · 45315

    Office

    $260.17

    Facility

    $100.44

    $2.69 lower than Merced for the office setting.

  • Beaumont

    Texas · 45315

    Office

    $233.83

    Facility

    $96.45

    $29.03 lower than Merced for the office setting.

  • Brazoria

    Texas · 45315

    Office

    $246.83

    Facility

    $97.21

    $16.03 lower than Merced for the office setting.

  • Dallas

    Texas · 45315

    Office

    $248.91

    Facility

    $98.54

    $13.95 lower than Merced for the office setting.

  • Fort Worth

    Texas · 45315

    Office

    $247.28

    Facility

    $98.42

    $15.58 lower than Merced for the office setting.

  • Galveston

    Texas · 45315

    Office

    $247.88

    Facility

    $97.96

    $14.98 lower than Merced for the office setting.

  • Houston

    Texas · 45315

    Office

    $255.75

    Facility

    $105.83

    $7.11 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 45315

    Office

    $240.53

    Facility

    $97.26

    $22.33 lower than Merced for the office setting.

  • Utah

    Utah · 45315

    Office

    $238.83

    Facility

    $96.91

    $24.03 lower than Merced for the office setting.

  • Virginia

    Virginia · 45315

    Office

    $243.87

    Facility

    $95.46

    $18.99 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45315

    Office

    $252.95

    Facility

    $100.32

    $9.91 lower than Merced for the office setting.

  • Vermont

    Vermont · 45315

    Office

    $242.27

    Facility

    $92.80

    $20.59 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 45315

    Office

    $258.08

    Facility

    $99.10

    $4.78 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 45315

    Office

    $292.49

    Facility

    $107.25

    $29.63 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 45315

    Office

    $233.62

    Facility

    $88.99

    $29.24 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 45315

    Office

    $233.61

    Facility

    $102.41

    $29.25 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 45315

    Office

    $247.44

    Facility

    $96.47

    $15.42 lower than Merced for the office setting.

See how rates vary across the country

45315 · 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.

$218.64

$296.82

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$284.241
AL$222.271
AR$218.641
AZ$243.481
CA$262.86–$330.7729
CO$260.301
CT$269.271
DC$288.081
DE$247.821
FL$250.42–$280.573
GA$234.34–$257.132
GU$269.981
HI$269.981
IA$227.101
ID$229.101
IL$243.48–$271.074
IN$230.551
KS$226.641
KY$229.821
LA$229.71–$242.432
MA$258.76–$287.052
MD$252.73–$288.083
ME$231.24–$244.242
MI$237.25–$254.682
MN$246.321
MO$225.77–$242.503
MS$222.221
MT$251.151
NC$233.841
ND$242.641
NE$228.281
NH$256.821
NJ$271.47–$284.662
NM$239.011
NV$248.961
NY$237.84–$301.315
OH$235.511
OK$228.571
OR$246.18–$268.522
PA$235.51–$262.382
PR$252.951
RI$256.661
SC$235.241
SD$241.641
TN$228.021
TX$233.83–$260.178
UT$238.831
VA$243.87–$288.082
VI$252.951
VT$242.271
WA$258.08–$292.492
WI$233.621
WV$233.611
WY$247.441

Explore 45315 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 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 45315 in Merced, the physician’s office rate is $262.86 and the facility-setting rate is $97.40: a difference of $165.46.

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 45315 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$289.15

$262.86 × 110% = $289.15

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 45315 in Merced.

PPRRVU2026_Oct_nonQPP.csv

5,493

Code
45315
Physician work
1.66
Practice expense
5.43
Malpractice
0.43

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 45315 in Merced
ComponentRVULocality factorAdjusted
Physician work1.66× 1.0171.6882
Practice expense5.43× 1.0965.9513
Malpractice0.43× 0.5360.2305
Total RVUs7.8700
Conversion factor× 33.4009

Office / nonfacility rate, Merced$262.86

Open 45315 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.661.017
Practice expense5.431.096
Malpractice0.430.536

(1.66 × 1.017 + 5.43 × 1.096 + 0.43 × 0.536) × $33.4009 = $262.86

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.661.017
Practice expense0.911.096
Malpractice0.430.536

(1.66 × 1.017 + 0.91 × 1.096 + 0.43 × 0.536) × $33.4009 = $97.40

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

45315 · Office / nonfacility

$262.86

Effective 2026-10-01

The base rate is $35.79 higher than on 2025-10-01, moving from $227.07 to $262.86 (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

    $227.07changed to$262.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.70 changed to 1.66
    • Practice expense RVU 4.62 changed to 5.43
    • Malpractice RVU 0.44 changed to 0.43
    • 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: $227.07

    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$262.86$97.40RVU26D
2026-07-01$262.86$97.40RVU26C
2026-04-01$262.86$97.40RVU26B
2026-01-01$262.86$97.40RVU26A
2025-10-01$227.07$101.56RVU25D
2025-07-01$227.07$101.56RVU25C
2025-04-01$227.07$101.56RVU25B
2025-01-01$227.07$101.56RVU25A

45315 billing questions

How is 45315 distinguished from flexible sigmoidoscopy with snare removal?

Use 45315 when the documented instrument is a rigid proctosigmoidoscope. Flexible sigmoidoscopy with snare removal is reported with 45338.

Is a diagnostic rigid proctosigmoidoscopy separately reported with 45315?

The examination performed as part of the snare removal is included. If another related endoscopy is separately reportable during the same session, CMS endoscopy family pricing applies.

What documentation supports 45315?

The procedure note should identify the rigid scope, the rectal or distal sigmoid lesion, and removal with a snare.

Does the 0-day global period include care on the procedure date?

Yes. Same-day preoperative and postoperative care for this minor procedure is included.

Can modifier 50 or surgical team billing be used for 45315?

Modifier 50 is inappropriate for this anatomy. CMS does not pay an assistant at surgery and does not permit co-surgeons or team surgery for this code.

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 45315PPRRVU2026_Oct_nonQPP.csv, line 5,493 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet