CPT 45333
Global 000 ActiveSigmoidoscopy & polypectomy
CPT 45333 Billing & Documentation Guide
CPT code 45333 (Sigmoidoscopy & polypectomy) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.51, a non-facility practice expense RVU of 9.29, and a malpractice RVU of 0.22, a total non-facility RVU of 11.02 and facility RVU of 2.59. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $381.59, though rates vary from $320.76 to $507.37 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 45333, 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 45333 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 45333 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 45333
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.51 | 1.51 |
| Practice Expense RVU | 9.29 | 0.86 |
| Malpractice RVU | 0.22 | 0.22 |
| Total RVU | 11.02 | 2.59 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 45333
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 | $423.39 | $90.21 | $395.31 - $507.37 | 29 |
| Florida | $376.07 | $93.56 | $358.12 - $392.04 | 3 |
| Georgia | $355.33 | $86.71 | $335.98 - $374.67 | 2 |
| Illinois | $364.48 | $92.41 | $345.22 - $382.48 | 4 |
| Michigan | $352.15 | $87.75 | $342.03 - $362.26 | 2 |
| North Carolina | $344.64 | $81.93 | $344.64 - $344.64 | 1 |
| New York | $408.98 | $94.86 | $350.38 - $436.25 | 5 |
| Ohio | $341.14 | $84.07 | $341.14 - $341.14 | 1 |
| Pennsylvania | $362.68 | $86.88 | $342.23 - $383.13 | 2 |
| Texas | $363.02 | $85.82 | $339.63 - $385.34 | 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 45333
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 45333 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 45333
What does CPT code 45333 mean? +
CPT code 45333 represents: Sigmoidoscopy & polypectomy. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 45333? +
The 2026 Medicare national average non-facility payment for CPT 45333 is $381.59. Rates range from $320.76 to $507.37 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 45333? +
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 45333? +
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 May 31, 2026.
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