$145.62–$160.12
45300 describes a rigid diagnostic examination. 45317 is appropriate when the examination includes endoscopic treatment to control bleeding.
On this page
CMS RVU26D · Effective 2026-10-01
45317 Bleeding control Medicare reimbursement rates in Florida
Reports rigid proctosigmoidoscopy used to locate and treat active bleeding in the rectum or distal sigmoid with endoscopic hemostasis. Compare 45317 office and facility rates across CMS payment localities in Florida.
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 45317 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$237.79–$262.38
3 of 3 localities have a supported rate.
Facility setting
$106.23–$119.12
3 of 3 localities have a supported rate.
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.
Where 45317 pays more and less in Florida
3 payment localities
$237.79 to $262.38
Endoscopy
About 45317: Rigid proctosigmoidoscopy with bleeding control
Reports rigid proctosigmoidoscopy used to locate and treat active bleeding in the rectum or distal sigmoid with endoscopic hemostasis.
A clinician advances a rigid proctosigmoidoscope through the anus to examine the rectum and distal sigmoid and treat a bleeding site. A gastroenterologist or colorectal surgeon may perform the service in an office, outpatient endoscopy unit, or hospital setting. Hemostasis may use an endoscopic technique such as cautery, injection, or another method suited to the bleeding source.
Report this code when the rigid examination includes active treatment to control bleeding, rather than a diagnostic examination alone. The procedure note should identify the bleeding site, the intervention used, and the result. 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. Bilateral adjustment is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 45317
- 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 RVU1.85 · 26%
- Practice expense (office) RVU5.04 · 70%
- Malpractice RVU0.30 · 4%
220
Medicare services in 2024 · #4238 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.
45317 compared with similar codes
Office rates for Florida, from the same CMS release.
$527.05–$574.67
45334 is the flexible sigmoidoscopy counterpart for bleeding control. Select the code that matches the instrument used and the examination documented.
$245.28–$275.04
45320 identifies rigid proctosigmoidoscopy with ablation. Use 45317 when the documented service is control of bleeding rather than ablation.
Compare 45317 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
$250.44
Facility
$111.04
Miami →
Office / nonfacility
$262.38
Facility
$119.12
Rest Of Florida →
Office / nonfacility
$237.79
Facility
$106.23
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45317 billing questions
How is this different from diagnostic proctosigmoidoscopy?
45317 includes endoscopic treatment to control bleeding. Use the diagnostic code when the rigid examination is performed without bleeding-control treatment.
How does this differ from 45334?
Both address endoscopic control of bleeding, but 45317 is for rigid proctosigmoidoscopy and 45334 is for flexible sigmoidoscopy. Choose according to the instrument and examination documented.
Can the diagnostic examination be billed separately?
The diagnostic examination that leads to bleeding-control treatment is part of the therapeutic endoscopy. Document the treatment performed and the bleeding site.
Should modifier 50 be appended?
No. The anatomy and service make bilateral adjustment inappropriate.
What happens when another related endoscopy is performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. Document each procedure and its distinct clinical purpose.
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.
5,49145308,,Proctosigmoidoscopy removal,A,,1.27,5.18,,0.82,,0.35,6.80,2.44,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49245309,,Proctosigmoidoscopy removal,A,,1.37,5.27,,0.84,,0.37,7.01,2.58,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49345315,,Proctosigmoidoscopy removal,A,,1.66,5.43,,0.91,,0.43,7.52,3.00,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49445317,,Proctosigmoidoscopy bleed,A,,1.85,5.04,,0.92,,0.30,7.19,3.07,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49545320,,Proctosigmoidoscopy ablate,A,,1.64,5.29,,0.91,,0.43,7.36,2.98,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49645321,,Proctosigmoidoscopy volvul,A,,1.61,0.90,NA,0.90,,0.43,2.94,2.94,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49745327,,Proctosigmoidoscopy w/stent,A,,1.85,0.96,NA,0.96,,0.48,3.29,3.29,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00