No office rate
Both describe endoscopic decompression, but 45321 is for rigid proctosigmoidoscopy. Select 45337 when a flexible sigmoidoscope is used.
On this page
CMS RVU26D · Effective 2026-10-01
45337 Sigmoidoscopy Medicare reimbursement rates in Washington
Flexible sigmoidoscopy with decompression is reported when an endoscopist relieves colonic distention, commonly during endoscopic management of sigmoid volvulus. Compare 45337 office and facility rates across CMS payment localities in Washington.
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 45337 in Washington?
Washington 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
No supported rate
Facility setting
$100.08–$107.13
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.
Gastrointestinal endoscopy
About 45337: Flexible sigmoidoscopic decompression
Flexible sigmoidoscopy with decompression is reported when an endoscopist relieves colonic distention, commonly during endoscopic management of sigmoid volvulus.
A physician advances a flexible endoscope through the rectum into the distal colon to relieve distention, often in a patient with acute sigmoid volvulus. The endoscopist may use suction and endoscopic maneuvers to decompress the affected segment; a decompression tube may also be used when clinically indicated. Gastroenterologists and colorectal surgeons commonly perform this service in a hospital setting for an urgent obstruction-related presentation.
Report this code when the documented service includes therapeutic decompression, rather than inspection alone or another distinct intervention such as biopsy or bleeding control. The procedure note should support the indication, scope used, relevant findings, and decompression performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this service; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 45337
- 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 RVU2.05 · 69%
- Practice expense (office) RVU0.70 · 23%
- Malpractice RVU0.24 · 8%
1.8K
Medicare services in 2024 · #2561 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.
45337 compared with similar codes
Office rates for Washington, from the same CMS release.
$224.24–$257.44
45330 represents diagnostic flexible sigmoidoscopy. Choose 45337 when the procedure includes therapeutic decompression, not inspection alone.
$337.26–$387.83
45331 is used when flexible sigmoidoscopy includes biopsy. Decompression, rather than tissue sampling, distinguishes 45337.
$568.19–$653.07
45334 describes endoscopic control of bleeding during flexible sigmoidoscopy. Use 45337 for decompression instead.
Compare 45337 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$100.08
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$107.13
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45337 billing questions
Can a biopsy or bleeding-control service be reported in the same session?
A separately performed intervention must be supported by the procedure documentation. When related endoscopies are performed together, CMS endoscopy-family pricing applies.
Can modifier 50 be appended?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
Is assistant-at-surgery payment available?
No. CMS applies a statutory restriction to assistant-at-surgery payment for this code; co-surgeons and team surgery are also not permitted.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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.
5,50145333,,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
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