$291.37
45330 is diagnostic, with brushing or washing included when performed. Use 45331 when the flexible sigmoidoscopy includes a tissue biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
45330 Flexible sigmoidoscopy Medicare reimbursement rates in Kentucky
A flexible scope examines the rectum and sigmoid colon to evaluate lower gastrointestinal symptoms when no biopsy or therapeutic procedure is performed. Compare 45330 office and facility rates across CMS payment localities in Kentucky.
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 45330 in Kentucky?
Kentucky 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
$194.37
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$50.95
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 45330: Diagnostic flexible sigmoidoscopy
A flexible scope examines the rectum and sigmoid colon to evaluate lower gastrointestinal symptoms when no biopsy or therapeutic procedure is performed.
A physician, commonly a gastroenterologist or colorectal surgeon, advances a flexible endoscope through the anus to inspect the rectum and sigmoid colon. The service is used to evaluate concerns such as rectal bleeding, altered bowel habits, or suspected distal-colon disease. Specimens collected by brushing or washing are included when performed; the code represents a diagnostic examination, not a tissue biopsy or lesion treatment.
Report 45330 when the examination is diagnostic and no separately coded intervention is performed. The report should support the indication, the portion of bowel examined, and the findings; document any brushing or washing when performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 45330
- 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 RVU0.82 · 13%
- Practice expense (office) RVU5.50 · 85%
- Malpractice RVU0.12 · 2%
45.9K
Medicare services in 2024 · #812 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.
45330 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$333.01
45330 describes diagnostic inspection without lesion removal. Use 45333 when a polyp is removed during flexible sigmoidoscopy.
$348.28
45330 examines the rectum and sigmoid colon with a flexible scope; 45378 is a diagnostic colonoscopy with a broader colonic examination.
Compare 45330 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
Kentucky →
Office / nonfacility
$194.37
Facility
$50.95
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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 45330 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
5,498
- Code
- 45330
- Physician work
- 0.82
- Practice expense
- 5.50
- Malpractice
- 0.12
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.82 | × 1.000 | 0.8200 |
| Practice expense | 5.50 | × 0.889 | 4.8895 |
| Malpractice | 0.12 | × 0.915 | 0.1098 |
| Total RVUs | 5.8193 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$194.37
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 5.5 | 0.889 |
| Malpractice | 0.12 | 0.915 |
(0.82 × 1 + 5.5 × 0.889 + 0.12 × 0.915) × $33.4009 = $194.37
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 0.67 | 0.889 |
| Malpractice | 0.12 | 0.915 |
(0.82 × 1 + 0.67 × 0.889 + 0.12 × 0.915) × $33.4009 = $50.95
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.
45330 billing questions
When should 45330 be reported instead of 45331?
Use 45330 for a diagnostic examination without tissue biopsy. When the physician obtains a biopsy during flexible sigmoidoscopy, report the biopsy service, 45331, rather than the diagnostic-only code.
Are brushing and washing separately billable?
No. Specimen collection by brushing or washing is included in 45330 when performed. A tissue biopsy or therapeutic maneuver is a different service.
Can 45330 be billed with a polypectomy code for the same examination?
When the same sigmoidoscopy includes polyp removal, report the applicable intervention code rather than separately reporting the diagnostic examination as 45330.
Should modifier 50 be appended for examination of both sides?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the sigmoidoscopy service.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, Medicare pays the highest-valued procedure in full and pays the other procedures at 50%.
What documentation supports 45330?
Document the diagnostic reason, scope examination and extent, findings, and any brushing or washing. If biopsy or treatment is performed, document that work and report the applicable procedure 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.
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
5,49845330,,Diagnostic sigmoidoscopy,A,,0.82,5.50,,0.67,,0.12,6.44,1.61,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,49945331,,Sigmoidoscopy and biopsy,A,,1.11,8.42,,0.75,,0.14,9.67,2.00,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50045332,,Sigmoidoscopy w/fb removal,A,,1.72,7.43,,0.93,,0.22,9.37,2.87,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50145333,,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
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631