CPT code 45505: Rectal repair, transanal approach2026 Medicare rate & RVUs in Santa Clara County, CA
Reports direct surgical closure of a rectal defect approached through the anal canal, such as a localized rectal injury accessible from below.
In Santa Clara County, CA, Medicare pays $715.50 for 45505 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 45505 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 45505 covers
This service involves reaching a rectal defect through the anal canal and closing it directly. A colorectal or general surgeon may perform it for a localized rectal wall injury or defect that can be exposed and repaired from below, typically in an operating room. The operative approach distinguishes this service from repairs requiring perineal or abdominal access.
Select the code from the approach and work documented, not from the diagnosis alone. The operative report should identify the rectal defect, its location, the transanal access, and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 Santa Clara County, CA compares for 45505
Across 109 of 109 payment localities, the facility rate for 45505 runs from $532.03 in Arkansas to $726.17 in Alaska. Santa Clara County, CA pays $715.50. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Santa Clara County, CA · this page$715.50
- Bakersfield, CA · California$606.54−$108.96
- Chico, CA · California$602.43−$113.07
- El Centro, CA · California$602.68−$112.82
- Fresno, CA · California$602.43−$113.07
- Hanford, CA · California$602.43−$113.07
- Los Angeles, CA · California$638.98−$76.52
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | — | $602.43 |
| Merced, CACalifornia | — | $602.43 |
| Modesto, CACalifornia | — | $602.43 |
| Napa, CACalifornia | — | $674.24 |
| Oxnard, CACalifornia | — | $633.17 |
| Redding, CACalifornia | — | $602.43 |
| Rest of CaliforniaCalifornia | — | $602.43 |
| Riverside, CACalifornia | — | $618.16 |
| Sacramento, CACalifornia | — | $625.91 |
| Salinas, CACalifornia | — | $623.46 |
| San Diego, CACalifornia | — | $633.59 |
| Marin County, CACalifornia | — | $705.70 |
| San Francisco, CACalifornia | — | $704.04 |
| San Benito County, CACalifornia | — | $722.28 |
| San Luis Obispo, CACalifornia | — | $614.18 |
| Santa Cruz, CACalifornia | — | $636.03 |
| Santa Maria, CACalifornia | — | $624.55 |
| Santa Rosa, CACalifornia | — | $642.04 |
| Stockton, CACalifornia | — | $602.43 |
| Vallejo, CACalifornia | — | $671.85 |
| Visalia, CACalifornia | — | $602.43 |
| Yuba City, CACalifornia | — | $602.43 |
| Washington, DC areaDistrict of Columbia | — | $663.05 |
| Miami, FLFlorida | — | $679.97 |
| Chicago, ILIllinois | — | $660.62 |
| Manhattan, NYNew York | — | $684.46 |
| AlaskaAlaska | — | $726.17 |
| AlabamaAlabama | — | $538.89 |
| ArkansasArkansas | — | $532.03 |
| ArizonaArizona | — | $578.71 |
| ColoradoColorado | — | $604.28 |
| ConnecticutConnecticut | — | $630.92 |
| DelawareDelaware | — | $587.36 |
| Fort Lauderdale, FLFlorida | — | $637.16 |
| Rest of FloridaFlorida | — | $606.71 |
| Atlanta, GAGeorgia | — | $609.19 |
| Rest of GeorgiaGeorgia | — | $574.06 |
| Hawaii, Guam, HIHawaii | — | $611.10 |
| IowaIowa | — | $541.57 |
| IdahoIdaho | — | $546.65 |
| East St. Louis, ILIllinois | — | $621.79 |
| Rest of IllinoisIllinois | — | $597.89 |
| Suburban Chicago, ILIllinois | — | $641.13 |
| IndianaIndiana | — | $549.19 |
| KansasKansas | — | $543.79 |
| KentuckyKentucky | — | $559.73 |
| New Orleans, LALouisiana | — | $584.71 |
| Rest of LouisianaLouisiana | — | $560.73 |
| Metropolitan Boston, MAMassachusetts | — | $653.00 |
| Rest of MassachusettsMassachusetts | — | $603.14 |
| Baltimore area, MDMaryland | — | $630.06 |
| Rest of MarylandMaryland | — | $596.20 |
| Rest of MaineMaine | — | $553.91 |
| Southern Maine, MEMaine | — | $573.75 |
| Detroit, MIMichigan | — | $618.09 |
| Rest of MichiganMichigan | — | $576.72 |
| MinnesotaMinnesota | — | $567.79 |
| Metropolitan Kansas City, MOMissouri | — | $576.41 |
| Metropolitan St. Louis, MOMissouri | — | $581.19 |
| Rest of MissouriMissouri | — | $555.23 |
| MississippiMississippi | — | $543.50 |
| MontanaMontana | — | $594.10 |
| North CarolinaNorth Carolina | — | $558.29 |
| North DakotaNorth Dakota | — | $565.24 |
| NebraskaNebraska | — | $542.83 |
| New HampshireNew Hampshire | — | $599.31 |
| Northern New JerseyNew Jersey | — | $658.38 |
| Rest of New JerseyNew Jersey | — | $634.96 |
| New MexicoNew Mexico | — | $581.33 |
| NevadaNevada | — | $586.33 |
| NYC suburbs and Long Island, NYNew York | — | $705.05 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $642.65 |
| Queens, NYNew York | — | $682.90 |
| Rest of New YorkNew York | — | $566.06 |
| OhioOhio | — | $570.82 |
| OklahomaOklahoma | — | $554.09 |
| Portland, OROregon | — | $616.40 |
| Rest of OregonOregon | — | $578.63 |
| Metropolitan Philadelphia, PAPennsylvania | — | $619.72 |
| Rest of PennsylvaniaPennsylvania | — | $569.12 |
| Puerto RicoPuerto Rico | — | $596.48 |
| Rhode IslandRhode Island | — | $603.12 |
| South CarolinaSouth Carolina | — | $566.12 |
| South DakotaSouth Dakota | — | $561.82 |
| TennesseeTennessee | — | $546.76 |
| Austin, TXTexas | — | $605.03 |
| Beaumont, TXTexas | — | $566.15 |
| Brazoria, TXTexas | — | $583.19 |
| Dallas, TXTexas | — | $588.63 |
| Fort Worth, TXTexas | — | $586.54 |
| Galveston, TXTexas | — | $586.08 |
| Houston, TXTexas | — | $612.80 |
| Rest of TexasTexas | — | $575.54 |
| UtahUtah | — | $572.83 |
| VirginiaVirginia | — | $575.22 |
| Virgin Islands, VIUnited States Virgin Islands | — | $596.48 |
| VermontVermont | — | $567.38 |
| Rest of WashingtonWashington | — | $600.57 |
| King County, WAWashington | — | $660.91 |
| WisconsinWisconsin | — | $548.98 |
| West VirginiaWest Virginia | — | $579.43 |
| WyomingWyoming | — | $581.52 |
45505 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 45505 rate is calculated
Each of 45505’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 · 45505
RVUs × geographic indexes × conversion factor
Work8.15
8.15 RVUs× 1.000 GPCI
Practice expense8.18
8.18 RVUs× 1.000 GPCI
Malpractice1.46
1.46 RVUs× 1.000 GPCI
Adjusted RVUs
17.7900
Conversion factor
$33.4009
Medicare rate
$594.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Santa Clara County, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,538
- Code
- 45505
- Physician work
- 8.15
- Practice expense
- 8.18
- Malpractice
- 1.46
GPCI2026.csv
28
- Locality
- Santa Clara County, CA
- Physician work
- 1.110
- Practice expense
- 1.442
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.15 | × 1.110 | 9.0465 |
| Practice expense | 8.18 | × 1.442 | 11.7956 |
| Malpractice | 1.46 | × 0.397 | 0.5796 |
| Total RVUs | 21.4217 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Santa Clara County, CA$715.50
Facility: (8.15 × 1.11 + 8.18 × 1.442 + 1.46 × 0.397) × $33.4009 = $715.50
Payment rules and modifiers for 45505
45505 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45505
Rectal repair, transanal approach
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 45505
Rectal repair, transanal 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45505 without 51 · national facility
$594.20
Rectal repair, transanal approach
45505-51 · Second procedure: 50%
$297.10
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%).
How 45505 has changed in Santa Clara County, CA
45505 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $715.50 | RVU26D |
| 2026-07-01 | Not available in this setting | $715.50 | RVU26C |
| 2026-04-01 | Not available in this setting | $715.50 | RVU26B |
| 2026-01-01 | Not available in this setting | $715.50 | RVU26A |
| 2025-10-01 | Not available in this setting | $710.83 | RVU25D |
| 2025-07-01 | Not available in this setting | $710.83 | RVU25C |
| 2025-04-01 | Not available in this setting | $710.83 | RVU25B |
| 2025-01-01 | Not available in this setting | $710.83 | RVU25A |
| 2024-10-01 | Not available in this setting | $724.09 | RVU24D |
| 2024-07-01 | Not available in this setting | $724.09 | RVU24C |
| 2024-04-01 | Not available in this setting | $724.09 | RVU24B |
| 2024-03-09 | Not available in this setting | $724.09 | RVU24AR |
| 2024-01-01 | Not available in this setting | $712.27 | RVU24A |
| 2023-10-01 | Not available in this setting | $725.46 | RVU23D |
| 2023-07-01 | Not available in this setting | $725.46 | RVU23C |
| 2023-04-01 | Not available in this setting | $725.46 | RVU23B |
| 2023-01-01 | Not available in this setting | $725.46 | RVU23A |
| 2022-10-01 | Not available in this setting | $726.43 | RVU22D |
| 2022-07-01 | Not available in this setting | $726.43 | RVU22C |
| 2022-04-01 | Not available in this setting | $726.43 | RVU22B |
| 2022-01-01 | Not available in this setting | $726.43 | RVU22A |
| 2021-10-01 | Not available in this setting | $723.00 | RVU21D |
| 2021-07-01 | Not available in this setting | $723.00 | RVU21C |
| 2021-04-01 | Not available in this setting | $723.00 | RVU21B |
| 2021-01-01 | Not available in this setting | $723.00 | RVU21A |
| 2020-10-01 | Not available in this setting | $717.34 | RVU20D |
| 2020-07-01 | Not available in this setting | $717.34 | RVU20C |
| 2020-04-01 | Not available in this setting | $717.34 | RVU20B |
| 2020-01-01 | Not available in this setting | $717.34 | RVU20A |
| 2019-10-01 | Not available in this setting | $702.44 | RVU19D |
| 2019-07-01 | Not available in this setting | $702.44 | RVU19C |
| 2019-04-01 | Not available in this setting | $702.44 | RVU19B |
| 2019-01-01 | Not available in this setting | $702.44 | RVU19A |
| 2018-10-01 | Not available in this setting | $699.37 | RVU18D |
| 2018-07-01 | Not available in this setting | $699.37 | RVU18C |
| 2018-04-01 | Not available in this setting | $699.37 | RVU18B |
| 2018-01-01 | Not available in this setting | $699.37 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $695.78 | RVU17D |
| 2017-07-01 | Not available in this setting | $695.78 | RVU17C |
| 2017-04-01 | Not available in this setting | $695.78 | RVU17B |
| 2017-01-01 | Not available in this setting | $695.78 | RVU17A |
| 2016-10-01 | Not available in this setting | $694.63 | RVU16D |
| 2016-07-01 | Not available in this setting | $694.63 | RVU16C |
| 2016-04-01 | Not available in this setting | $694.63 | RVU16B |
| 2016-01-01 | Not available in this setting | $694.63 | RVU16A |
| 2015-10-01 | Not available in this setting | $699.92 | RVU15D |
| 2015-07-01 | Not available in this setting | $699.92 | RVU15C |
| 2015-04-01 | Not available in this setting | $696.44 | RVU15B |
| 2015-01-01 | Not available in this setting | $696.44 | RVU15A |
| 2014-10-01 | Not available in this setting | $691.62 | RVU14D |
| 2014-07-01 | Not available in this setting | $691.62 | RVU14C |
| 2014-04-01 | Not available in this setting | $691.62 | RVU14B |
| 2014-01-01 | Not available in this setting | $691.62 | RVU14A |
| 2013-10-01 | Not available in this setting | $693.11 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Santa Clara County, CA rate applies
Santa Clara County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 24 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
45505 billing questions
How does this differ from 45500?
The approach is the key distinction: 45505 is for repair reached through the anal canal, while 45500 represents a perineal approach. The operative report should support the approach used.
When would an abdominal repair code be more appropriate?
Use the applicable abdominal exploration-and-repair code when the surgeon explores and repairs the rectum through an abdominal approach. Codes 45562 and 45563 are alternatives to consider for that operative circumstance.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50 for the rectal repair.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The global period is tied to this major surgery.
What documentation supports reporting 45505?
Document the rectal defect or injury, the transanal route used to reach it, and the repair performed. Those details distinguish this service from perineal or abdominal repair.
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
Fee sheets
Put 45505 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →