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

Reports abdominal surgery to excise rectal prolapse, distinguished from perineal excision and from procedures that suspend the rectum without excising it.

CMS RVU26DEffective Oct 1, 2026One payment locality21 Medicare services in 2024

In Montana, Medicare pays $1,195.88 for 45135 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,195.88Hospital or facility

Check a contract rate as a % of Medicare · 45135 nationwide

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

We’ll open 45135 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 45135 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Montana compares for 45135

Across 109 of 109 payment localities, the facility rate for 45135 runs from $1,094.14 in Arkansas to $1,536.84 in Alaska. Montana pays $1,195.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

45135 in Montana vs other payment areas
  1. Montana · this page$1,195.88
  2. Los Angeles, CA · California$1,257.32+$61.44
  3. Washington, DC area · District of Columbia$1,311.90+$116.02
  4. Miami, FL · Florida$1,370.83+$174.95
  5. Chicago, IL · Illinois$1,338.39+$142.51
  6. Manhattan, NY · New York$1,362.82+$166.94
  7. Alaska · Alaska$1,536.84+$340.96

Other areas in Montana first, then benchmark localities. Bars start at $0.

Every other payment area

45135 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,105.29
ArkansasArkansas—$1,094.14
ArizonaArizona—$1,169.77
Bakersfield, CACalifornia—$1,203.93
Chico, CACalifornia—$1,194.84
El Centro, CACalifornia—$1,195.37
Fresno, CACalifornia—$1,194.84
Hanford, CACalifornia—$1,194.84

45135 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
45135 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 45135 in every payment locality

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.

How the rate is built · 45135

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.80

21.80 RVUs× 1.000 GPCI

Practice expense10.88

10.88 RVUs× 1.000 GPCI

Malpractice3.13

3.13 RVUs× 1.000 GPCI

Adjusted RVUs

35.8100

Conversion factor

$33.4009

Medicare rate

$1,196.09

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,478

Code
45135
Physician work
21.80
Practice expense
10.88
Malpractice
3.13

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Facility calculation for 45135 in Montana
ComponentRVULocality factorAdjusted
Physician work21.80× 1.00021.8000
Practice expense10.88× 1.00010.8800
Malpractice3.13× 0.9983.1237
Total RVUs35.8037
Conversion factor× 33.4009

Facility rate, Montana$1195.88

Facility: (21.8 × 1 + 10.88 × 1 + 3.13 × 0.998) × $33.4009 = $1195.88

Open 45135 in the RVU calculator

Payment rules and modifiers for 45135

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

CMS payment indicators · 45135

Rectal prolapse excision, abdominal approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 45135

Rectal prolapse excision, abdominal approach

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45135 without 51 · national facility

$1,196.09

Rectal prolapse excision, abdominal approach

45135-51 · Second procedure: 50%

$598.05

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 45135 has changed in Montana

45135 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,195.88RVU26D
2026-07-01Not available in this setting$1,195.88RVU26C
2026-04-01Not available in this setting$1,195.88RVU26B
2026-01-01Not available in this setting$1,195.88RVU26A
2025-10-01Not available in this setting$1,253.56RVU25D
2025-07-01Not available in this setting$1,253.56RVU25C
2025-04-01Not available in this setting$1,253.56RVU25B
2025-01-01Not available in this setting$1,253.56RVU25A
2024-10-01Not available in this setting$1,284.34RVU24D
2024-07-01Not available in this setting$1,284.34RVU24C
2024-04-01Not available in this setting$1,284.34RVU24B
2024-03-09Not available in this setting$1,284.34RVU24AR
2024-01-01Not available in this setting$1,263.38RVU24A
2023-10-01Not available in this setting$1,300.42RVU23D
2023-07-01Not available in this setting$1,300.42RVU23C
2023-04-01Not available in this setting$1,300.42RVU23B
2023-01-01Not available in this setting$1,300.42RVU23A
2022-10-01Not available in this setting$1,314.76RVU22D
2022-07-01Not available in this setting$1,314.76RVU22C
2022-04-01Not available in this setting$1,314.76RVU22B
2022-01-01Not available in this setting$1,314.76RVU22A
2021-10-01Not available in this setting$1,313.53RVU21D
2021-07-01Not available in this setting$1,313.53RVU21C
2021-04-01Not available in this setting$1,313.53RVU21B
2021-01-01Not available in this setting$1,313.53RVU21A
2020-10-01Not available in this setting$1,380.55RVU20D
2020-07-01Not available in this setting$1,380.55RVU20C
2020-04-01Not available in this setting$1,380.55RVU20B
2020-01-01Not available in this setting$1,380.55RVU20A
2019-10-01Not available in this setting$1,431.77RVU19D
2019-07-01Not available in this setting$1,431.77RVU19C
2019-04-01Not available in this setting$1,431.77RVU19B
2019-01-01Not available in this setting$1,431.77RVU19A
2018-10-01Not available in this setting$1,434.92RVU18D
2018-07-01Not available in this setting$1,434.92RVU18C
2018-04-01Not available in this setting$1,434.92RVU18B
2018-01-01Not available in this setting$1,434.92RVU18AR1
2017-10-01Not available in this setting$1,500.12RVU17D
2017-07-01Not available in this setting$1,500.12RVU17C
2017-04-01Not available in this setting$1,500.12RVU17B
2017-01-01Not available in this setting$1,500.12RVU17A
2016-10-01Not available in this setting$1,463.91RVU16D
2016-07-01Not available in this setting$1,463.91RVU16C
2016-04-01Not available in this setting$1,463.91RVU16B
2016-01-01Not available in this setting$1,463.91RVU16A
2015-10-01Not available in this setting$1,476.56RVU15D
2015-07-01Not available in this setting$1,476.56RVU15C
2015-04-01Not available in this setting$1,469.21RVU15B
2015-01-01Not available in this setting$1,469.21RVU15A
2014-10-01Not available in this setting$1,429.00RVU14D
2014-07-01Not available in this setting$1,429.00RVU14C
2014-04-01Not available in this setting$1,429.00RVU14B
2014-01-01Not available in this setting$1,429.00RVU14A
2013-10-01Not available in this setting$1,396.31RVU13D
2013-07-01Not available in this setting$1,396.31RVU13C
2013-04-01Not available in this setting$1,396.31RVU13B
2013-01-01Not available in this setting$1,396.31RVU13AR

Price 45135 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

45135 billing questions

How does this differ from 45130?

45135 is for excision of rectal prolapse through an abdominal approach. 45130 describes the perineal approach; follow the operative report rather than the diagnosis alone.

Is rectopexy alone reported with this code?

No. This code describes excision of prolapsed rectal tissue through an abdominal approach. A rectopexy without excision is a different procedure, such as 45540.

Can modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation.

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

Show the CMS file lines behind this rate
RVUs for 45135PPRRVU2026_Oct_nonQPP.csv, line 5,478 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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