$230.64
45300 describes diagnostic examination with a rigid scope; 45330 is the diagnostic flexible sigmoidoscopy code.
On this page
CMS RVU26D · Effective 2026-10-01
45300 Proctosigmoidoscopy Medicare reimbursement rates in Connecticut
Reports rigid-scope examination of the rectum and distal sigmoid for diagnostic evaluation, including brushing or washing specimen collection when performed. Compare 45300 office and facility rates across CMS payment localities in Connecticut.
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.
What does Medicare pay for 45300 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$159.17
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$47.66
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Endoscopy
About 45300: Rigid diagnostic proctosigmoidoscopy
Reports rigid-scope examination of the rectum and distal sigmoid for diagnostic evaluation, including brushing or washing specimen collection when performed.
A physician passes a rigid scope through the anus to examine the rectum and distal sigmoid, commonly to evaluate rectal bleeding, pain, or a suspected distal lesion. Brushing or washing to collect specimens is included when performed. Gastroenterologists and colorectal surgeons may perform the examination in an office or facility setting.
Select this code for a diagnostic rigid examination; a documented biopsy or therapeutic maneuver may call for a different procedure code. The report should identify the indication, examination findings, and any brushing or washing performed. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 45300
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- 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 RVU0.78 · 18%
- Practice expense (office) RVU3.54 · 80%
- Malpractice RVU0.13 · 3%
13.2K
Medicare services in 2024 · #1334 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.
45300 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$212.43
Use 45305 when the rigid examination includes biopsy; 45300 covers diagnostic examination, including brushing or washing when performed.
$346.37
45331 describes flexible sigmoidoscopy with biopsy. Distinguish it from rigid examination with biopsy, reported with 45305.
Compare 45300 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$159.17
Facility
$47.66
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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 45300 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
5,487
- Code
- 45300
- Physician work
- 0.78
- Practice expense
- 3.54
- Malpractice
- 0.13
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.78 | × 1.020 | 0.7956 |
| Practice expense | 3.54 | × 1.077 | 3.8126 |
| Malpractice | 0.13 | × 1.210 | 0.1573 |
| Total RVUs | 4.7655 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$159.17
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.78 | 1.02 |
| Practice expense | 3.54 | 1.077 |
| Malpractice | 0.13 | 1.21 |
(0.78 × 1.02 + 3.54 × 1.077 + 0.13 × 1.21) × $33.4009 = $159.17
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.78 | 1.02 |
| Practice expense | 0.44 | 1.077 |
| Malpractice | 0.13 | 1.21 |
(0.78 × 1.02 + 0.44 × 1.077 + 0.13 × 1.21) × $33.4009 = $47.66
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.
45300 billing questions
How does 45300 differ from diagnostic flexible sigmoidoscopy?
45300 is for examination with a rigid scope. Use 45330 when the examination is performed with a flexible sigmoidoscope.
Can brushing or washing be reported separately?
No. Brushing or washing specimen collection is included in 45300 when performed.
Can a biopsy be reported as 45300?
No. A biopsy is a distinct service; 45305 describes rigid proctosigmoidoscopy with biopsy.
What should the procedure note support?
Document the diagnostic indication, rigid scope examination and findings, and whether brushing or washing was performed.
How does the multiple-procedure rule affect payment?
For procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
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.
5,48445190,,Destruction rectal tumor,A,,10.16,8.52,NA,8.52,,1.45,20.13,20.13,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4854525F,,Neuropsychia interven order,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4864526F,,Neuropsychia interven rcvd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48745300,,Proctosigmoidoscopy dx,A,,0.78,3.54,,0.44,,0.13,4.45,1.35,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48845303,,Proctosigmoidoscopy dilate,A,,1.37,29.10,,0.80,,0.23,30.70,2.40,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,48945305,,Proctosigmoidoscopy w/bx,A,,1.12,4.62,,0.75,,0.20,5.94,2.07,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49045307,,Proctosigmoidoscopy fb,A,,1.56,5.10,,0.89,,0.42,7.08,2.87,0,000,0.00,0.00,0.00,3,0,0,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808