45321 Proctosigmoidoscopy volvul
Also known as: proctoscopy with volvulus decompression, sigmoidoscopy with decompression
Proctosigmoidoscopy with decompression of sigmoid volvulus (twisted bowel) via needle decompression or tube placement.
In Plain Language
untwisting of twisted colon; relief of bowel obstruction from twisting
Clinical Context
Emergency procedure for acute sigmoid volvulus presenting with abdominal pain and obstruction, potentially avoiding surgery if successful decompression achieved.
RVU Breakdown
| Work RVU | 1.61 |
| Total RVU | 1.61 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 0-day global period, meaning pre- and post-operative E&M visits are billable separately on the same day. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 1.61, this code ranks in the 10th percentile among Surgery codes — 5.0x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 45321?
CPT 45321 (Proctosigmoidoscopy volvul) is a Surgery code. Proctosigmoidoscopy with decompression of sigmoid volvulus (twisted bowel) via needle decompression or tube placement.
What is the wRVU value for CPT 45321?
The work RVU for CPT 45321 is 1.61. This code is primarily used by Colorectal Surgery, Gastroenterology, Emergency Medicine.
When is CPT 45321 used?
Emergency procedure for acute sigmoid volvulus presenting with abdominal pain and obstruction, potentially avoiding surgery if successful decompression achieved.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.