CPT 45332
Global 000 ActiveSigmoidoscopy w/fb removal
CPT 45332 Billing & Documentation Guide
CPT code 45332 (Sigmoidoscopy w/fb removal) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.72, a non-facility practice expense RVU of 7.43, and a malpractice RVU of 0.22, a total non-facility RVU of 9.37 and facility RVU of 2.87. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $323.91, though rates vary from $274.41 to $425.57 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 45332, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 45332 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 45332 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 45332
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.72 | 1.72 |
| Practice Expense RVU | 7.43 | 0.93 |
| Malpractice RVU | 0.22 | 0.22 |
| Total RVU | 9.37 | 2.87 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 45332
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $357.15 | $100.25 | $334.36 - $425.57 | 29 |
| Florida | $320.75 | $102.92 | $305.74 - $334.38 | 3 |
| Georgia | $303.09 | $95.97 | $287.58 - $318.59 | 2 |
| Illinois | $311.49 | $101.71 | $295.51 - $325.74 | 4 |
| Michigan | $300.82 | $96.96 | $292.32 - $309.32 | 2 |
| North Carolina | $293.69 | $91.13 | $293.69 - $293.69 | 1 |
| New York | $347.02 | $104.82 | $298.38 - $369.84 | 5 |
| Ohio | $291.43 | $93.22 | $291.43 - $291.43 | 1 |
| Pennsylvania | $308.9 | $96.25 | $292.21 - $325.59 | 2 |
| Texas | $308.91 | $95.17 | $290.11 - $326.64 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 45332
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 45332 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00731 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00732 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00740 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00810 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00811 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00812 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00813 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0184T | Column 1 (primary), can be billed with modifier | No | More extensive procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 45332
What does CPT code 45332 mean? +
CPT code 45332 represents: Sigmoidoscopy w/fb removal. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 45332? +
The 2026 Medicare national average non-facility payment for CPT 45332 is $323.91. Rates range from $274.41 to $425.57 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 45332? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 45332? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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