No office rate
45327 uses rigid proctosigmoidoscopy for stent placement. 45347 describes stent placement using a flexible sigmoidoscope.
On this page
CMS RVU26D · Effective 2026-10-01
45347 Sigmoidoscopy stenting Medicare reimbursement rates in Wyoming
Reports flexible sigmoidoscopy with placement of a stent across a narrowed large-bowel segment, commonly to relieve obstruction from a colorectal lesion. Compare 45347 office and facility rates across CMS payment localities in Wyoming.
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 45347 in Wyoming?
Wyoming 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
$134.00
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 45347: Flexible sigmoidoscopy with stent placement
Reports flexible sigmoidoscopy with placement of a stent across a narrowed large-bowel segment, commonly to relieve obstruction from a colorectal lesion.
A gastroenterologist or colorectal surgeon advances a flexible endoscope through the rectum into the sigmoid or left colon and places a stent across a narrowed segment. A typical setting is a hospital or endoscopy unit treating a large-bowel obstruction, often from a colorectal tumor. The stent bridges the stenosis to restore or maintain passage through the bowel. Guidewire passage and dilation before or after stent placement, when performed, are part of this service.
Report 45347 when the documented procedure includes stent placement by flexible sigmoidoscopy, rather than diagnostic inspection alone or dilation without stenting. The operative report should identify the stenosis site and indication, scope used, and stent deployment. 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. CMS does not pay an assistant at surgery for this service; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 45347
- 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 RVU2.65 · 65%
- Practice expense (office) RVU1.14 · 28%
- Malpractice RVU0.30 · 7%
552
Medicare services in 2024 · #3467 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.
45347 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$214.06
45330 is a diagnostic flexible sigmoidoscopy. It does not describe placement of a stent across a narrowing.
$505.88
45340 covers balloon dilation of a narrowed segment; 45347 is selected when a stent is placed.
No office rate
Both codes describe endoscopic stent placement, but 45389 uses a colonoscope while 45347 uses a flexible sigmoidoscope.
Compare 45347 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$134.00
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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 45347 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,510
- Code
- 45347
- Physician work
- 2.65
- Practice expense
- 1.14
- Malpractice
- 0.30
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.65 | × 1.000 | 2.6500 |
| Practice expense | 1.14 | × 1.000 | 1.1400 |
| Malpractice | 0.30 | × 0.740 | 0.2220 |
| Total RVUs | 4.0120 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$134.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.65 | 1 |
| Practice expense | 1.14 | 1 |
| Malpractice | 0.3 | 0.74 |
(2.65 × 1 + 1.14 × 1 + 0.3 × 0.74) × $33.4009 = $134.00
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.
45347 billing questions
Is dilation separately reported with stent placement?
Pre- and post-dilation and guidewire passage, when performed as part of the stent procedure, are included in 45347. Do not separately report those components as though they were independent procedures.
How does 45347 differ from 45340?
45347 is for stent placement. Choose 45340 when the endoscopic treatment is balloon dilation of a narrowing and no stent is placed.
Can an assistant-at-surgery or co-surgeon be billed?
CMS does not pay an assistant at surgery for 45347. Co-surgeon and team-surgery billing are not permitted for this service.
What happens when another related endoscopy is performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. Document each distinct service performed and the findings supporting it.
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.
5,50745341,,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
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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,