CPT code 45402: Laparoscopic rectopexy, with sigmoid resection2026 Medicare rate & RVUs

Medicare pays $1,392.82 for 45402 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 45402 covers

The surgeon uses laparoscopic abdominal access to mobilize and secure the prolapsing rectum and remove a segment of sigmoid colon. This combined operation is used to treat rectal prolapse, including cases where sigmoid resection is part of the operative plan. It is generally performed by a colorectal or general surgeon in a hospital operating room, with the patient under general anesthesia.

Report this code when the operative record supports both laparoscopic rectopexy for prolapse and sigmoid resection; the resection distinguishes it from laparoscopic rectopexy without resection. Documentation should identify the approach, rectal prolapse, and the resection performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery services 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 45402 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

45402 rates by state

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

How the 45402 rate is calculated

Each of 45402’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 45402

45402 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

45402 compared with similar codes

How to choose

45400RectopexyLaparoscopic, without resection

Choose 45400 for laparoscopic rectopexy without sigmoid resection. The resection is the key distinction for 45402.

45550Rectal repairWith sigmoid resection

45550 describes abdominal rectopexy with sigmoid resection using an open approach; 45402 is the laparoscopic approach.

45540Rectal prolapse repairAbdominal approach

45540 is open abdominal rectopexy without sigmoid resection. 45402 includes sigmoid resection and uses laparoscopic access.

Codes related to 45402

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