Home / Medicare fees / 45330

45330 Diagnostic sigmoidoscopy

What 45330 is

CMS fee schedule short descriptor: Diagnostic sigmoidoscopy.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 45330 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)0.825.500.126.44$215.10
Facility (hospital, ASC)0.820.670.121.61$53.78

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 45330 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 45330? These codes are bundled into it

45330 is a Column 1 code in 269 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
00731Anes upr gi ndsc px nos0 - no modifier bypassCheck pair
00732Anes upr gi ndsc px ercp0 - no modifier bypassCheck pair
00811Anes lwr intst ndsc nos0 - no modifier bypassCheck pair
00812Anes lwr intst scr colsc0 - no modifier bypassCheck pair
00813Anes upr lwr gi ndsc px0 - no modifier bypassCheck pair
0184TExc rectal tumor endoscopic0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0632TPerq tcat us abltj nrv p-art1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair

Showing 30 of 269 column 2 codes. Use the pair checker for any specific combination.

45330 is bundled into these codes

45330 appears as a Column 2 code in 41 active edits. Reported with one of these Column 1 codes on the same date of service, 45330 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0885TColsc flx 1st tndsc dilat1Check pair
0886TSgmdsc flx 1st tndsc dilat0Check pair
44140Partial removal of colon1Check pair
44141Partial removal of colon1Check pair
44143Partial removal of colon1Check pair
44144Partial removal of colon1Check pair
44145Partial removal of colon1Check pair
45332Sigmoidoscopy w/fb removal0Check pair
45333Sigmoidoscopy & polypectomy0Check pair
45334Sigmoidoscopy for bleeding0Check pair
45335Sigmoidoscopy w/submuc inj0Check pair
45337Sigmoidoscopy & decompress0Check pair
45338Sigmoidoscopy w/tumr remove0Check pair
45340Sig w/tndsc balloon dilation0Check pair
45341Sigmoidoscopy w/ultrasound0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.