$348.71
45333 describes lesion removal by snare technique. Choose 45349 when the documented intervention is EMR.
On this page
CMS RVU26D · Effective 2026-10-01
45349 Endoscopic mucosal resection Medicare reimbursement rates in Utah
Reports endoscopic mucosal resection of a lesion reached by flexible sigmoidoscopy, typically when a colorectal lesion is lifted and removed endoscopically. Compare 45349 office and facility rates across CMS payment localities in Utah.
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 45349 in Utah?
Utah 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
$171.16
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Gastrointestinal endoscopy
About 45349: Flexible sigmoidoscopy with endoscopic mucosal resection
Reports endoscopic mucosal resection of a lesion reached by flexible sigmoidoscopy, typically when a colorectal lesion is lifted and removed endoscopically.
A gastroenterologist or colorectal surgeon uses a flexible sigmoidoscope to reach a lesion in the rectum or sigmoid colon and perform endoscopic mucosal resection (EMR). The technique commonly involves lifting the lesion from the underlying wall, often with a submucosal injection, then removing the targeted mucosa with an endoscopic resection instrument. It is performed in an endoscopy setting for lesions selected for endoscopic rather than surgical removal.
Report this code when the documented therapeutic service is EMR during flexible sigmoidoscopy, not merely inspection, biopsy, or routine snare removal. The report should identify the lesion’s location and describe the EMR technique and resection performed. Medicare 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; CMS also does not pay an assistant at surgery, and does not permit co-surgeons or team surgery for this service.
CMS billing rules for 45349
- 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 RVU3.43 · 65%
- Practice expense (office) RVU1.43 · 27%
- Malpractice RVU0.39 · 7%
780
Medicare services in 2024 · #3179 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.
45349 compared with similar codes
Office rates for Utah, from the same CMS release.
Compare 45349 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
Utah →
Office / nonfacility
Unavailable
Facility
$171.16
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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 45349 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,511
- Code
- 45349
- Physician work
- 3.43
- Practice expense
- 1.43
- Malpractice
- 0.39
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.43 | × 1.000 | 3.4300 |
| Practice expense | 1.43 | × 0.940 | 1.3442 |
| Malpractice | 0.39 | × 0.898 | 0.3502 |
| Total RVUs | 5.1244 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$171.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.43 | 1 |
| Practice expense | 1.43 | 0.94 |
| Malpractice | 0.39 | 0.898 |
(3.43 × 1 + 1.43 × 0.94 + 0.39 × 0.898) × $33.4009 = $171.16
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.
45349 billing questions
How does this differ from 45333?
Use 45349 for EMR performed through flexible sigmoidoscopy. Code 45333 describes a different lesion-removal technique, snare removal, rather than EMR.
Can diagnostic sigmoidoscopy be reported separately with the EMR?
The inspection that leads to EMR is part of the therapeutic endoscopy. When related endoscopies are performed together, Medicare applies endoscopy family pricing.
What documentation supports reporting 45349?
Document the lesion’s location and the EMR technique and resection performed. The record should distinguish EMR from biopsy, diagnostic examination, or another removal method.
Should modifier 50 be appended for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this service and does not permit co-surgeons or team surgery.
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.
5,50845342,,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
5,51245350,,Sgmdsc w/band ligation,A,,1.64,20.41,,0.90,,0.21,22.26,2.75,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45330,33.4009,09,0,99,0.00,0.00,0.00
5,51345378,,Diagnostic colonoscopy,A,,3.18,7.73,,1.34,,0.41,11.32,4.93,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,51445378,53,Diagnostic colonoscopy,A,,1.59,3.87,,0.67,,0.21,5.67,2.47,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985