Home / Medicare fees / 45349

45349 Sigmoidoscopy w/resection

What 45349 is

CMS fee schedule short descriptor: Sigmoidoscopy w/resection.

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 45349 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)3.431.430.395.25$175.35
Facility (hospital, ASC)3.431.430.395.25$175.35

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 45349 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 45349? These codes are bundled into it

45349 is a Column 1 code in 294 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
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - 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

Showing 30 of 294 column 2 codes. Use the pair checker for any specific combination.

45349 is bundled into these codes

45349 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 45349 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0885TColsc flx 1st tndsc dilat1Check pair
45350Sgmdsc w/band ligation1Check pair
45378Diagnostic colonoscopy0Check pair
45379Colonoscopy w/fb removal0Check pair
45380Colonoscopy and biopsy0Check pair
45381Colonoscopy submucous njx0Check pair
45382Colonoscopy w/control bleed0Check pair
45384Colonoscopy w/lesion removal0Check pair
45385Colonoscopy w/lesion removal0Check pair
45386Colonoscopy w/balloon dilat1Check pair
45388Colonoscopy w/ablation0Check pair
45389Colonoscopy w/stent plcmt0Check pair
45390Colonoscopy w/resection0Check pair
45391Colonoscopy w/endoscope us0Check pair
45392Colonoscopy w/endoscopic fnb0Check 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.