$198.28–$225.35
45330 is for diagnostic flexible sigmoidoscopy without treatment. Use 45334 when the endoscopist treats a bleeding site during the procedure.
On this page
CMS RVU26D · Effective 2026-10-01
45334 Flexible sigmoidoscopy Medicare reimbursement rates in Texas
Reports flexible endoscopic examination of the rectum and distal colon when the endoscopist actively treats a bleeding site during the procedure. Compare 45334 office and facility rates across CMS payment localities in Texas.
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 45334 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$501.13–$570.75
8 of 8 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 45334 pays more and less in Texas
8 payment localities
$501.13 to $570.75
Gastroenterology endoscopy
About 45334: Flexible sigmoidoscopy with bleeding control
Reports flexible endoscopic examination of the rectum and distal colon when the endoscopist actively treats a bleeding site during the procedure.
A gastroenterologist or colorectal surgeon uses a flexible endoscope to examine the rectum and distal colon and treat a bleeding site, such as a bleeding lesion or a bleeding point seen during evaluation of hematochezia. Hemostasis may be achieved with an endoscopic technique such as injection, thermal treatment, or a clip. The code reflects treatment of bleeding, not visualization alone.
Report it when the procedure note supports endoscopic treatment intended to control bleeding, including the site and method used. A diagnostic examination performed as part of the same treatment session is not a separate service merely because the endoscopist first inspected the area. 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 45334
- 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 RVU1.95 · 12%
- Practice expense (office) RVU14.12 · 87%
- Malpractice RVU0.22 · 1%
3.5K
Medicare services in 2024 · #2086 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.
45334 compared with similar codes
Office rates for Texas, from the same CMS release.
$297.34–$338.84
45331 includes biopsy during flexible sigmoidoscopy. This code is for endoscopic treatment to control bleeding.
$339.63–$385.34
45333 is for snare removal of a polyp. This code is appropriate when the documented intervention is control of bleeding.
$224.29–$248.90
Both codes address endoscopic bleeding control, but 45317 is for rigid proctosigmoidoscopy; 45334 is for flexible sigmoidoscopy.
Compare 45334 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $570.75 | Facility $107.11 |
| Beaumont | Office $501.13 | Facility $102.35 |
| Brazoria | Office $538.76 | Facility $104.48 |
| Dallas | Office $541.76 | Facility $105.29 |
| Fort Worth | Office $537.14 | Facility $105.05 |
| Galveston | Office $540.06 | Facility $104.90 |
| Houston | Office $544.08 | Facility $108.93 |
| Rest Of Texas | Office $519.34 | Facility $103.46 |
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45334 billing questions
Can the diagnostic examination be billed separately when bleeding is treated?
The inspection that leads to treatment during the same session is part of the therapeutic service. Document the bleeding site and the treatment performed.
How does this differ from flexible sigmoidoscopy with biopsy?
Code 45331 describes a procedure that includes tissue sampling. This code describes endoscopic treatment directed at controlling bleeding.
How does this differ from the polypectomy code?
Code 45333 is for removal of a polyp by snare technique. Choose this code when the service performed is control of bleeding, rather than polyp removal.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this procedure. CMS does not permit co-surgeons or team surgery for it.
What documentation supports reporting this service?
The report should identify the bleeding site and describe the endoscopic technique used to control it. A note documenting only examination or a finding of blood does not establish that bleeding was treated.
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.
5,49945331,,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
5,50245334,,Sigmoidoscopy for bleeding,A,,1.95,14.12,,1.00,,0.22,16.29,3.17,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50345335,,Sigmoidoscopy w/submuc inj,A,,1.01,8.67,,0.72,,0.14,9.82,1.87,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50445337,,Sigmoidoscopy & decompress,A,,2.05,0.70,NA,0.70,,0.24,2.99,2.99,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,50545338,,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