CPT 45300 Surgery - Digestive
Proctosigmoidoscopy dx Cost
Body System: Digestive
Medicare Facility Rate
$45
CMS PFS CY2026
Medicare Non-Facility Rate
$149
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.78
Work RVU
0.44
Facility PE RVU
0.13
Malpractice RVU
4.45
Total RVU
Frequently Asked Questions
How much does Proctosigmoidoscopy dx cost?
The Medicare facility rate is $45. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Proctosigmoidoscopy dx cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $45.