CPT code 45135: Rectal prolapse excision, abdominal approach2026 Medicare rate & RVUs

Medicare pays $1,196.09 for 45135 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 45135 covers

This code describes an abdominal operation to remove tissue involved in rectal prolapse. A colorectal or general surgeon typically performs the procedure in a hospital operating room for a patient whose prolapse is being treated through an abdominal approach. The operative report should make the approach and excision clear, and describe the prolapse and any reconstruction performed. It is distinct from perineal excision, which uses a different operative route.

Choose this code when the documented operation excises the prolapsed rectum through an abdominal approach; do not select it solely because the surgeon treats prolapse. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 45135 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

45135 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 45135 rate is calculated

Each of 45135’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 45135

45135 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

45135 compared with similar codes

How to choose

45130Rectal prolapse repairPerineal mucosal excision

Both codes address excision of rectal prolapse, but 45135 uses an abdominal approach and 45130 uses a perineal approach.

45540Rectal prolapse repairAbdominal approach

45540 describes abdominal rectopexy to treat prolapse. Use 45135 when the documented operation includes abdominal excision of prolapsed rectal tissue.

45550Rectal repairWith sigmoid resection

45550 combines abdominal rectopexy with sigmoid resection. Distinguish it from 45135 by the documented procedure and whether rectopexy with sigmoid resection was performed.

Codes related to 45135

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates