FLEXIBLE SIGMOIDOSCOPY - Medicare payment - CPT 45330, 45331

2010 Medicare GI Endoscopy Procedure Reimbursement Guide for FLEXIBLE SIGMOIDOSCOPY

FLEXIBLE SIGMOIDOSCOPY		Ambulatory Surgery Center		Outpatient Hospital	Physician Services
Code	Procedure Description	ASC Facility Fee (National Medicare Avg)	APC	Facility Fee Schedule (National Medicare Avg)²	Fee When Procedure Performed in Hospital or ASC (National Medicare Avg)³	Fee When Procedure Performed in Office (National Medicare Avg)³
45330	Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)	$89.13	0146	$389.25	$60.98	$127.74
45331	…with biopsy, single or multiple	$245.07	0146	$389.25	$73.97	$160.58
45332	…with removal of foreign body	$245.07	0146	$389.25	$107.89	$265.22
45333	…with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery	$357.42	0147	$623.17	$107.89	$268.11
45334	…with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)	$357.42	0147	$623.17	$162.38	NA*
45335	…with directed submucosal injection(s), any substance	$245.07	0146	$389.25	$89.85	$230.94
45338	…with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	$357.42	0147	$623.17	$139.29	$296.98
45339	…with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique	$357.42	0147	$623.17	$184.03	$312.13
45340	…with dilation by balloon, 1 or more strictures	$357.42	0147	$623.17	$113.67	$412.45
45341	…with endoscopic ultrasound examination	$357.42	0147	$623.17	$155.16	NA*
45342	…with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)	$357.42	0147	$623.17	$237.08	NA*
45345	…with transendoscopic stent placement (includes predilation)	$875.58	0384	$1,785.67	$172.48	NA*