$145.35–$171.58
Use 45300 for diagnostic rigid proctosigmoidoscopy without dilation. Use 45303 when the endoscopist dilates a narrowing during the examination.
On this page
CMS RVU26D · Effective 2026-10-01
45303 Proctosigmoidoscopy Medicare reimbursement rates in Virginia
Report rigid proctosigmoidoscopy with dilation when the endoscopist treats a narrowing in the rectum or distal sigmoid under direct visualization. Compare 45303 office and facility rates across CMS payment localities in Virginia.
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 45303 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$1006.63–$1201.76
2 of 2 localities have a supported rate.
Facility setting
$77.45–$88.26
2 of 2 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.
Endoscopy
About 45303: Rigid proctosigmoidoscopy with dilation
Report rigid proctosigmoidoscopy with dilation when the endoscopist treats a narrowing in the rectum or distal sigmoid under direct visualization.
This service combines examination of the rectum and distal sigmoid with dilation of a narrowing seen during rigid proctosigmoidoscopy. A gastroenterologist, colorectal surgeon, or other qualified endoscopist may perform it when a stricture limits passage through the examined segment. The clinician uses a dilation method suited to the narrowing and the patient; the procedure is therapeutic, not simply an inspection of the area.
Report the service when the record supports both rigid proctosigmoidoscopic examination and dilation. Document the narrowing’s location, the treatment performed, and the findings. 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 for an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 45303
- 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 RVU1.37 · 4%
- Practice expense (office) RVU29.10 · 95%
- Malpractice RVU0.23 · 1%
536
Medicare services in 2024 · #3493 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.
45303 compared with similar codes
Office rates for Virginia, from the same CMS release.
$193.81–$228.64
45305 includes biopsy with rigid proctosigmoidoscopy. It describes tissue sampling, while 45303 describes dilation of a narrowing.
$497.85–$592.25
45340 describes dilation with flexible sigmoidoscopy. Choose between it and 45303 based on the scope type used for the procedure.
Compare 45303 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$1201.76
Facility
$88.26
Virginia →
Office / nonfacility
$1006.63
Facility
$77.45
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
45303 billing questions
How does this differ from 45300?
45300 describes rigid proctosigmoidoscopy for diagnostic examination alone. Report 45303 when the examination includes dilation of a narrowing.
How does this differ from 45340?
45303 is for dilation performed with rigid proctosigmoidoscopy. 45340 describes dilation performed with flexible sigmoidoscopy.
What documentation supports this code?
Document the rigid examination, the narrowing’s location, and the dilation performed. The record should make clear that treatment occurred, not just diagnostic inspection.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are related endoscopies priced when performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed together. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant-at-surgery claim for this service. Co-surgeon and team-surgery billing are not permitted.
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.
5,4854525F,,Neuropsychia interven order,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4864526F,,Neuropsychia interven rcvd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48745300,,Proctosigmoidoscopy dx,A,,0.78,3.54,,0.44,,0.13,4.45,1.35,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48845303,,Proctosigmoidoscopy dilate,A,,1.37,29.10,,0.80,,0.23,30.70,2.40,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,48945305,,Proctosigmoidoscopy w/bx,A,,1.12,4.62,,0.75,,0.20,5.94,2.07,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45300,33.4009,09,0,99,0.00,0.00,0.00
5,49045307,,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