45309
Active0-day globalProctosigmoidoscopy removal
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 45309 | 1 | $234.14 | $86.17 |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 45309 | 1.37 | 5.27 | 0.84 | 0.37 | 7.01 |
Payment policy for 45309
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=3Endoscopy rule
Special multiple-endoscopy rules apply within the same endoscopy family, then standard ranking.
Bilateral (modifier 50)
bilt_surg=0150% rule doesn't apply
Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).
Assistant surgeon (80/81/82)
asst_surg=1Not payable
Assistant at surgery may not be paid for this procedure.
Co-surgeons (modifier 62)
co_surg=0Not permitted
Co-surgeons (mod 62) may not be paid for this procedure.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.