CPT 45347
Global 000 ActiveSigmoidoscopy w/plcmt stent
CPT 45347 Billing & Documentation Guide
CPT code 45347 (Sigmoidoscopy w/plcmt stent) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.65, a non-facility practice expense RVU of 1.14, and a malpractice RVU of 0.3, a total non-facility RVU of 4.09 and facility RVU of 4.09. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $138.64, though rates vary from $126.38 to $178.84 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 45347, 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 45347 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 45347 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 45347
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.65 | 2.65 |
| Practice Expense RVU | 1.14 | 1.14 |
| Malpractice RVU | 0.3 | 0.3 |
| Total RVU | 4.09 | 4.09 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 45347
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 | $142.17 | $142.17 | $137.12 - $158.53 | 29 |
| Florida | $146.22 | $146.22 | $139.97 - $153.49 | 3 |
| Georgia | $136.96 | $136.96 | $134.42 - $139.5 | 2 |
| Illinois | $144.76 | $144.76 | $138.94 - $150.4 | 4 |
| Michigan | $138.37 | $138.37 | $134.59 - $142.15 | 2 |
| North Carolina | $130.44 | $130.44 | $130.44 - $130.44 | 1 |
| New York | $148.81 | $148.81 | $131.73 - $158.06 | 5 |
| Ohio | $133.38 | $133.38 | $133.38 - $133.38 | 1 |
| Pennsylvania | $137.32 | $137.32 | $132.94 - $141.7 | 2 |
| Texas | $135.79 | $135.79 | $132.47 - $140.82 | 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 45347
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 45347 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 45347
What does CPT code 45347 mean? +
CPT code 45347 represents: Sigmoidoscopy w/plcmt stent. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 45347? +
The 2026 Medicare national average non-facility payment for CPT 45347 is $138.64. Rates range from $126.38 to $178.84 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 45347? +
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 45347? +
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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