CPT 45305 Surgery - Digestive
Proctosigmoidoscopy w/bx Cost
Body System: Digestive
Medicare Facility Rate
$69
CMS PFS CY2026
Medicare Non-Facility Rate
$198
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.12
Work RVU
0.75
Facility PE RVU
0.20
Malpractice RVU
5.94
Total RVU
Frequently Asked Questions
How much does Proctosigmoidoscopy w/bx cost?
The Medicare facility rate is $69. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Proctosigmoidoscopy w/bx 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 $69.