CPT code 45541: Prolapse repair, perineal approach2026 Medicare rate & RVUs

Medicare pays $890.80 for 45541 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 45541 covers

CPT 45541 describes surgical correction of rectal prolapse through the perineum rather than through an abdominal approach. A colorectal or general surgeon may perform a Delorme-type operation, which can involve removing a sleeve of rectal mucosa and plicating the underlying muscle. The service is generally performed in an operating room for a patient with prolapse extending through the anus; the operative report should identify the perineal route and the corrective work performed.

Report the code when the documented operation matches perineal repair, not abdominal rectopexy or a distinct prolapse excision procedure. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this operation.

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 45541 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

45541 rates by state

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

How the 45541 rate is calculated

Each of 45541’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 45541

45541 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

45541 compared with similar codes

How to choose

45540Rectal prolapse repairAbdominal approach

Choose 45541 for a perineal repair; 45540 describes an abdominal approach.

45550Rectal repairWith sigmoid resection

45550 describes abdominal prolapse repair with sigmoid resection. It is not the perineal repair represented by 45541.

45130Rectal prolapse repairPerineal mucosal excision

45130 represents perineal excision of rectal prolapse. Use 45541 when the documented service is repair rather than that excision procedure.

45400RectopexyLaparoscopic, without resection

45400 describes laparoscopic abdominal repair, while 45541 is for repair performed through a perineal approach.

Codes related to 45541

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