$312.47
Both involve snare removal, but 45315 uses a rigid proctosigmoidoscope; 45338 uses a flexible sigmoidoscope.
On this page
CMS RVU26D · Effective 2026-10-01
45315 Proctosigmoidoscopy Medicare reimbursement rates in Ohio
Report this service when a clinician uses a rigid proctosigmoidoscope to remove a rectal or distal sigmoid polyp or other lesion with a snare. Compare 45315 office and facility rates across CMS payment localities in Ohio.
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 45315 in Ohio?
Ohio 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
$235.51
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$97.67
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
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 Ohio, from the same CMS release.
$185.03
Choose 45305 for a biopsy through a rigid proctosigmoidoscope, rather than removal of a lesion with a snare.
$138.38
45300 represents the diagnostic rigid examination. Use 45315 when that examination includes documented snare removal.
Compare 45315 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
Ohio →
Office / nonfacility
$235.51
Facility
$97.67
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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 45315 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,493
- Code
- 45315
- Physician work
- 1.66
- Practice expense
- 5.43
- Malpractice
- 0.43
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.66 | × 1.000 | 1.6600 |
| Practice expense | 5.43 | × 0.913 | 4.9576 |
| Malpractice | 0.43 | × 1.008 | 0.4334 |
| Total RVUs | 7.0510 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$235.51
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.66 | 1 |
| Practice expense | 5.43 | 0.913 |
| Malpractice | 0.43 | 1.008 |
(1.66 × 1 + 5.43 × 0.913 + 0.43 × 1.008) × $33.4009 = $235.51
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.66 | 1 |
| Practice expense | 0.91 | 0.913 |
| Malpractice | 0.43 | 1.008 |
(1.66 × 1 + 0.91 × 0.913 + 0.43 × 1.008) × $33.4009 = $97.67
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.
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.
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
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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703