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CPT code 45500: Rectal injury repair, injury-related proctoplasty2026 Medicare rate & RVUs in Kansas

Surgical proctoplasty repairs an injury to the rectum, including anorectal sphincter repair when needed, during an operative encounter.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Kansas, Medicare pays $512.74 for 45500 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$512.74Hospital or facility

Check a contract rate as a % of Medicare · 45500 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 45500 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kansas
  2. What 45500 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 45500 covers

This operation repairs an injured rectum through a proctoplasty approach; the repair may also involve the anorectal sphincter when that structure is injured. It is typically performed by a colorectal or general surgeon in an operating room for a rectal injury requiring operative repair. The operative report should identify the injury and describe the repair performed, including any sphincter repair.

Report 45500 when the documented service is injury-related proctoplasty, rather than reconstruction for rectal narrowing or repair through a different operative approach. The Medicare global period includes 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 multiple procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity.

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 Kansas compares for 45500

Across 109 of 109 payment localities, the facility rate for 45500 runs from $502.18 in Arkansas to $691.28 in NYC suburbs and Long Island, NY. Kansas pays $512.74. The RVUs are the same everywhere; the geographic indexes change the dollars.

45500 in Kansas vs other payment areas
  1. Kansas · this page$512.74
  2. Los Angeles, CA · California$603.89+$91.15
  3. Washington, DC area · District of Columbia$636.05+$123.31
  4. Miami, FL · Florida$683.10+$170.36
  5. Chicago, IL · Illinois$660.11+$147.37
  6. Manhattan, NY · New York$666.30+$153.56
  7. Alaska · Alaska$682.26+$169.52

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

Every other payment area

45500 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$509.62
ArkansasArkansas—$502.18
ArizonaArizona—$552.70
Bakersfield, CACalifornia—$572.80
Chico, CACalifornia—$567.40
El Centro, CACalifornia—$567.73
Fresno, CACalifornia—$567.40
Hanford, CACalifornia—$567.40

45500 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
45500 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 45500 in every payment locality

How the 45500 rate is calculated

Each of 45500’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 · 45500

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.54

7.54 RVUs× 1.000 GPCI

Practice expense7.52

7.52 RVUs× 1.000 GPCI

Malpractice2.01

2.01 RVUs× 1.000 GPCI

Adjusted RVUs

17.0700

Conversion factor

$33.4009

Medicare rate

$570.15

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

The exact Kansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,537

Code
45500
Physician work
7.54
Practice expense
7.52
Malpractice
2.01

GPCI2026.csv

54

Locality
Kansas
Physician work
1.000
Practice expense
0.904
Malpractice
0.504
Facility calculation for 45500 in Kansas
ComponentRVULocality factorAdjusted
Physician work7.54× 1.0007.5400
Practice expense7.52× 0.9046.7981
Malpractice2.01× 0.5041.0130
Total RVUs15.3511
Conversion factor× 33.4009

Facility rate, Kansas$512.74

Facility: (7.54 × 1 + 7.52 × 0.904 + 2.01 × 0.504) × $33.4009 = $512.74

Open 45500 in the RVU calculator

Payment rules and modifiers for 45500

45500 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45500

Rectal injury repair, injury-related proctoplasty

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 45500

Rectal injury repair, injury-related proctoplasty

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

45500 without 51 · national facility

$570.15

Rectal injury repair, injury-related proctoplasty

45500-51 · Second procedure: 50%

$285.08

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

Codes related to 45500

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

Codes related to 45500
CodeHow it relatesOffice range, Kansas
Same family
45505Rectal repair, transanal approachRelated proctoplasty code for rectal stenosis rather than injury.No office rate
Used instead
45562Rectal injury repair, transabdominal explorationUsed for transabdominal exploration and repair of rectal injury.No office rate
45563Rectal repair, with colostomyTransabdominal exploration and rectal injury repair when a colostomy is also performed.No office rate

How 45500 has changed in Kansas

45500 · 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$512.74RVU26D
2026-07-01Not available in this setting$512.74RVU26C
2026-04-01Not available in this setting$512.74RVU26B
2026-01-01Not available in this setting$512.74RVU26A
2025-10-01Not available in this setting$509.52RVU25D
2025-07-01Not available in this setting$509.52RVU25C
2025-04-01Not available in this setting$509.52RVU25B
2025-01-01Not available in this setting$509.52RVU25A
2024-10-01Not available in this setting$519.15RVU24D
2024-07-01Not available in this setting$519.15RVU24C
2024-04-01Not available in this setting$519.15RVU24B
2024-03-09Not available in this setting$519.15RVU24AR
2024-01-01Not available in this setting$510.68RVU24A
2023-10-01Not available in this setting$523.73RVU23D
2023-07-01Not available in this setting$523.73RVU23C
2023-04-01Not available in this setting$523.73RVU23B
2023-01-01Not available in this setting$523.73RVU23A
2022-10-01Not available in this setting$532.51RVU22D
2022-07-01Not available in this setting$532.51RVU22C
2022-04-01Not available in this setting$532.51RVU22B
2022-01-01Not available in this setting$532.51RVU22A
2021-10-01Not available in this setting$530.90RVU21D
2021-07-01Not available in this setting$530.90RVU21C
2021-04-01Not available in this setting$530.90RVU21B
2021-01-01Not available in this setting$530.90RVU21A
2020-10-01Not available in this setting$537.35RVU20D
2020-07-01Not available in this setting$537.35RVU20C
2020-04-01Not available in this setting$537.35RVU20B
2020-01-01Not available in this setting$537.35RVU20A
2019-10-01Not available in this setting$535.40RVU19D
2019-07-01Not available in this setting$535.40RVU19C
2019-04-01Not available in this setting$535.40RVU19B
2019-01-01Not available in this setting$535.40RVU19A
2018-10-01Not available in this setting$530.22RVU18D
2018-07-01Not available in this setting$530.22RVU18C
2018-04-01Not available in this setting$530.22RVU18B
2018-01-01Not available in this setting$530.22RVU18AR1
2017-10-01Not available in this setting$506.09RVU17D
2017-07-01Not available in this setting$506.09RVU17C
2017-04-01Not available in this setting$506.09RVU17B
2017-01-01Not available in this setting$506.09RVU17A
2016-10-01Not available in this setting$503.44RVU16D
2016-07-01Not available in this setting$503.44RVU16C
2016-04-01Not available in this setting$503.44RVU16B
2016-01-01Not available in this setting$503.44RVU16A
2015-10-01Not available in this setting$509.20RVU15D
2015-07-01Not available in this setting$509.20RVU15C
2015-04-01Not available in this setting$506.67RVU15B
2015-01-01Not available in this setting$506.67RVU15A
2014-10-01Not available in this setting$513.14RVU14D
2014-07-01Not available in this setting$513.14RVU14C
2014-04-01Not available in this setting$513.14RVU14B
2014-01-01Not available in this setting$513.14RVU14A
2013-10-01Not available in this setting$512.27RVU13D
2013-07-01Not available in this setting$512.27RVU13C
2013-04-01Not available in this setting$512.27RVU13B
2013-01-01Not available in this setting$512.27RVU13AR

Price 45500 for an earlier date of service

Where the Kansas rate applies

Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Kansas

45500 billing questions

How does 45500 differ from 45505?

45500 is for proctoplasty to repair an injury. 45505 is the related proctoplasty code for treatment of rectal stenosis.

When is 45562 a better fit?

Consider 45562 when the documented service is transabdominal exploration and repair of a rectal injury, rather than the proctoplasty represented by 45500.

Are related postoperative visits separately reported?

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

When can an assistant at surgery be reported?

Medicare assistant-at-surgery payment requires documentation that the assistant was medically necessary.

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 45500PPRRVU2026_Oct_nonQPP.csv, line 5,537 (RVU26D)
Geographic factors for KansasGPCI2026.csv, line 54 (RVU26D)

Open CMS sourceHow we calculate rates

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