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    v1.0.30
    OpenPayerBilling CodesEndoscopy Procedures on the RectumCPT cpt-45308-proctosigmoidoscopic-lesion-removal
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    CPT 45308: Proctosigmoidoscopy with Removal of Single Lesion

    Medicare pays $235 on average nationally for this procedure.

    CPT code 45308 describes a diagnostic and operative proctosigmoidoscopy in which a provider uses a rigid proctosigmoidoscope to examine the anus, rectum, and sigmoid colon and removes a single tumor, polyp, or other lesion using hot biopsy forceps or bipolar cautery; service type: operative endoscopic lesion removal; typical site of service: ambulatory surgery center or hospital outpatient department (endoscopy/procedure suite).

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient presents to an outpatient endoscopy suite with several weeks of intermittent rectal bleeding and a palpable rectal mass on digital rectal exam. After bowel prep as directed and informed consent, the patient undergoes a proctosigmoidoscopy in an outpatient surgical/procedural room. Using a rigid proctosigmoid scope, the provider inspects the anal canal, rectum, and distal sigmoid colon. A single 8–12 mm sessile polyp is visualized approximately 10 cm from the anal verge. The provider applies hot biopsy forceps/bipolar cautery and removes the lesion, achieving hemostasis. Specimen is sent to pathology; brief recovery and discharge instructions provided.

    Common clinical workflow steps:

    • Pre-procedure evaluation and informed consent in the clinic or pre-op area

    • Bowel preparation and appropriate sedation or local anesthesia in the procedure room

    • Performance of rigid proctosigmoidoscopy with lesion identification

    • Excisional removal of a single lesion using hot biopsy forceps or bipolar cautery (CPT 45308)

    • Specimen labeling and submission to pathology

    • Immediate assessment for bleeding and application of hemostatic measures as needed

    • Recovery in PACU/ambulatory recovery area and discharge with follow-up instructions

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    45300Proctosigmoidoscopy; diagnostic, rigidOften performed immediately before 45308 for diagnostic inspection of the distal colon prior to lesion removal.
    45305Proctosigmoidoscopy; with biopsy, single or multipleAlternative when cold biopsy forceps are used instead of hot biopsy or cautery; may be performed if only biopsy indicated.
    45309Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forcepsHigher-level endoscopic polypectomy for more proximal lesions; not billed with 45308 but related when an extended flexible scope procedure is required.
    45331Sigmoidoscopy, flexible; diagnostic, with biopsyPerformed when flexible approach is chosen instead of rigid proctosigmoidoscopy; may precede or replace 45308 depending on findings.
    88305Pathology examination, surgical specimen, intermediate complexityTypically billed by pathology for histologic evaluation of the excised lesion obtained during .

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    207L00000X
    363L00000X
    207LP2900X
    3418M1110X
    246ZN0300X
    207RS0010X
    1835G0303X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-45300-PROCTOSIGMOIDOSCOPY-RIGID-DIAGNOSTIC

    CPT 45300: Diagnostic Proctosigmoidoscopy with Rigid Proctoscope

    CPT-45303-PROCTOSIGMOIDOSCOPY-WITH-STRICTURE-DILATION

    CPT 45303: Proctosigmoidoscopy with Stricture Dilation

    CPT-45305-PROCTOSIGMOIDOSCOPY-WITH-BIOPSY

    CPT 45305: Proctosigmoidoscopy with Biopsy

    CPT-45307-PROCTOSIGMOIDOSCOPY-LOWER-GI-ENDOSCOPY

    CPT 45307: Proctosigmoidoscopy of Rectum and Sigmoid Colon

    CPT-45309-PROCTOSIGMOIDOSCOPY-SNARE-EXCISION-LESION

    CPT 45309: Proctosigmoidoscopy with Snare Polypectomy

    CPT-45315-PROCTOSIGMOIDOSCOPIC-POLYPECTOMY-MULTIPLE-LESIONS

    CPT 45315: Proctosigmoidoscopy with Multiple Lesion Removal

    CPT-45317-PROCTOSIGMOIDOSCOPY-WITH-HEMOSTASIS

    CPT 45317: Therapeutic Proctosigmoidoscopy for Hemorrhage Control

    CPT-45320-PROCTOSIGMOIDOSCOPIC-LESION-ABLATION

    CPT 45320: Proctosigmoidoscopic Ablation of Lesion

    CPT-45321-PROCTOSIGMOIDOSCOPIC-DECOMPRESSION-SIGMOID-VOLVULUS

    CPT 45321: Proctosigmoidoscopic Decompression of Volvulus

    CPT-45327-PROCTOSIGMOIDOSCOPIC-STENT-PLACEMENT-FOR-RECTAL-SIGMOID-STRICTURE

    CPT 45327: Proctosigmoidoscopy with Stent Placement

    Showing 1–10 of 39

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    45308