No office rate
Choose 45342 when endoscopic ultrasound guides needle aspiration or biopsy. Choose 45341 for ultrasound examination without guided needle sampling.
On this page
CMS RVU26D · Effective 2026-10-01
45342 Sigmoidoscopy Medicare reimbursement rates in Mississippi
Reports flexible sigmoidoscopy with endoscopic ultrasound-guided needle sampling of a distal intestinal lesion or nearby target for tissue diagnosis. Compare 45342 office and facility rates across CMS payment localities in Mississippi.
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 45342 in Mississippi?
Mississippi 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
No supported rate
Facility setting
$142.61
1 of 1 localities have a supported rate.
Payment area: Mississippi
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.
Gastroenterology
About 45342: Flexible sigmoidoscopy with ultrasound-guided sampling
Reports flexible sigmoidoscopy with endoscopic ultrasound-guided needle sampling of a distal intestinal lesion or nearby target for tissue diagnosis.
This procedure combines flexible examination of the rectum and sigmoid colon with endoscopic ultrasound imaging and needle aspiration or biopsy of a target. Gastroenterologists commonly use it to sample a subepithelial rectal or sigmoid lesion, or a nearby structure, when routine mucosal forceps biopsy may not reach the target. It is typically performed in an endoscopy suite, hospital outpatient department, or ambulatory surgery center.
Report 45342 when the endoscopic ultrasound is used to guide needle tissue sampling; documentation should identify the target and show that ultrasound guidance and sampling were performed. A standard mucosal biopsy without ultrasound-guided needle sampling is a different service. 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. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 45342
- 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 RVU2.91 · 64%
- Practice expense (office) RVU1.27 · 28%
- Malpractice RVU0.36 · 8%
402
Medicare services in 2024 · #3736 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.
45342 compared with similar codes
Office rates for Mississippi, from the same CMS release.
$282.67
45331 is for sigmoidoscopy with routine mucosal biopsy. 45342 involves ultrasound-guided needle sampling of a target.
No office rate
45392 describes ultrasound-guided sampling performed during colonoscopy; 45342 is the sigmoidoscopy approach.
Compare 45342 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
Mississippi →
Office / nonfacility
Unavailable
Facility
$142.61
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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 45342 in Mississippi.
PPRRVU2026_Oct_nonQPP.csv
5,508
- Code
- 45342
- Physician work
- 2.91
- Practice expense
- 1.27
- Malpractice
- 0.36
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.91 | × 1.000 | 2.9100 |
| Practice expense | 1.27 | × 0.861 | 1.0935 |
| Malpractice | 0.36 | × 0.739 | 0.2660 |
| Total RVUs | 4.2695 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Mississippi$142.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.91 | 1 |
| Practice expense | 1.27 | 0.861 |
| Malpractice | 0.36 | 0.739 |
(2.91 × 1 + 1.27 × 0.861 + 0.36 × 0.739) × $33.4009 = $142.61
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.
45342 billing questions
How does 45342 differ from 45341?
45342 includes endoscopic ultrasound-guided needle aspiration or biopsy. Use 45341 when ultrasound examination is performed without guided needle sampling.
Can a routine mucosal biopsy support 45342?
No. 45342 describes ultrasound-guided needle sampling; a routine forceps biopsy of the mucosal lining is a different service.
Should the diagnostic sigmoidoscopy be billed separately?
The code includes the sigmoidoscopic examination needed to perform the ultrasound-guided sampling. Do not separately report a diagnostic examination for that same service.
What documentation supports reporting 45342?
Document the lesion or target, the endoscopic ultrasound findings, and the needle aspiration or biopsy performed under ultrasound guidance.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for 45342.
What happens when related endoscopies are performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The service has a 0-day global period, so same-day preoperative and postoperative care is included.
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.
5,50545338,,Sigmoidoscopy w/tumr remove,A,,2.00,7.78,,1.01,,0.25,10.03,3.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50645340,,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
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974