Sigmoidoscopy, flexible; with biopsy, single or multiple

CPT 45330 is the billing code for "Sigmoidoscopy, flexible; with biopsy, single or multiple". For flexible sigmoidoscopy with biopsy of sigmoid colon or rectum

Medicare pays approximately $180.17 for CPT 45330 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 45330 has a total RVU of 6.11, broken down as: Work RVU 2.10, Practice Expense RVU 3.80, and Malpractice RVU 0.21. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 45330 include: Indication for sigmoidoscopy and biopsy; Location of each biopsy site; Number of biopsies taken; Endoscopic appearance of biopsied lesions. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 45330: Includes sigmoidoscopy. Includes single or multiple biopsies Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 45330 include: 59 (Distinct procedural service if performed with other procedures), 33 (Preventive service when performed for screening), 52 (Reduced services if procedure not completed). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 45330 is 15-25 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.