CPT code 45402: Laparoscopic rectopexy, with sigmoid resection2026 Medicare rate & RVUs in Florida
Reports laparoscopic fixation of a prolapsing rectum combined with sigmoid colon resection, typically as operative treatment for full-thickness rectal prolapse.
CMS doesn’t publish an office rate for 45402 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $1,532.73 |
| Miami, FL | Unavailable | $1,663.52 |
| Rest of Florida | Unavailable | $1,461.06 |
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.
How the rate is built · 45402
RVUs × geographic indexes × conversion factor
Work25.85
25.85 RVUs× 1.000 GPCI
Practice expense10.84
10.84 RVUs× 1.000 GPCI
Malpractice5.01
5.01 RVUs× 1.000 GPCI
Adjusted RVUs
41.7000
Conversion factor
$33.4009
Medicare rate
$1,392.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45402
45402 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45402
Laparoscopic rectopexy, with sigmoid resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 45402
Laparoscopic rectopexy, with sigmoid resection
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45402 without 51 · national facility
$1,392.82
Laparoscopic rectopexy, with sigmoid resection
45402-51 · Second procedure: 50%
$696.41
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%).
45402 compared with similar codes
Compare codes · National
4 codes, side by side
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.
45402 billing questions
When should 45402 be chosen instead of 45400?
Use 45402 when laparoscopic rectopexy for prolapse is performed with sigmoid colon resection. Use 45400 for laparoscopic rectopexy without that resection.
Is the sigmoid resection separately reported?
The resection is part of the combined service represented by 45402. Do not separately report another code for the same sigmoid resection.
What documentation supports 45402?
The operative report should establish rectal prolapse, laparoscopic access, rectopexy, and sigmoid resection. The record should distinguish the procedure from rectopexy without resection.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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