CPT code 45541: Prolapse repair, perineal approach2026 Medicare rate & RVUs in Delaware
Reports operative correction of rectal prolapse through a perineal approach, such as a Delorme-type repair performed by a colorectal or general surgeon.
In Delaware, Medicare pays $879.62 for 45541 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 45541 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 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.
How Delaware compares for 45541
Across 109 of 109 payment localities, the facility rate for 45541 runs from $799.73 in Arkansas to $1,108.79 in Alaska. Delaware pays $879.62. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Delaware · this page$879.62
- Los Angeles, CA · California$934.35+$54.73
- Washington, DC area · District of Columbia$983.03+$103.41
- Miami, FL · Florida$1,053.12+$173.50
- Chicago, IL · Illinois$1,022.47+$142.85
- Manhattan, NY · New York$1,029.21+$149.59
- Alaska · Alaska$1,108.79+$229.17
Other areas in Delaware first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $809.67 |
| ArkansasArkansas | — | $799.73 |
| ArizonaArizona | — | $867.12 |
| Bakersfield, CACalifornia | — | $891.42 |
| Chico, CACalifornia | — | $883.31 |
| El Centro, CACalifornia | — | $883.80 |
| Fresno, CACalifornia | — | $883.31 |
| Hanford, CACalifornia | — | $883.31 |
| Madera, CACalifornia | — | $883.31 |
| Merced, CACalifornia | — | $883.31 |
| Modesto, CACalifornia | — | $883.31 |
| Napa, CACalifornia | — | $971.48 |
| Oxnard, CACalifornia | — | $923.74 |
| Redding, CACalifornia | — | $883.31 |
| Rest of CaliforniaCalifornia | — | $883.31 |
| Riverside, CACalifornia | — | $914.81 |
| Sacramento, CACalifornia | — | $913.22 |
| Salinas, CACalifornia | — | $909.56 |
| San Diego, CACalifornia | — | $921.11 |
| Marin County, CACalifornia | — | $1,010.61 |
| San Francisco, CACalifornia | — | $1,007.29 |
| San Benito County, CACalifornia | — | $1,035.30 |
| Santa Clara County, CACalifornia | — | $1,021.70 |
| San Luis Obispo, CACalifornia | — | $896.61 |
| Santa Cruz, CACalifornia | — | $922.05 |
| Santa Maria, CACalifornia | — | $910.28 |
| Santa Rosa, CACalifornia | — | $930.42 |
| Stockton, CACalifornia | — | $883.31 |
| Vallejo, CACalifornia | — | $966.68 |
| Visalia, CACalifornia | — | $883.31 |
| Yuba City, CACalifornia | — | $883.31 |
| ColoradoColorado | — | $894.97 |
| ConnecticutConnecticut | — | $944.84 |
| Fort Lauderdale, FLFlorida | — | $973.90 |
| Rest of FloridaFlorida | — | $926.42 |
| Atlanta, GAGeorgia | — | $916.87 |
| Rest of GeorgiaGeorgia | — | $876.19 |
| Hawaii, Guam, HIHawaii | — | $891.97 |
| IowaIowa | — | $805.50 |
| IdahoIdaho | — | $814.48 |
| East St. Louis, ILIllinois | — | $965.29 |
| Rest of IllinoisIllinois | — | $918.99 |
| Suburban Chicago, ILIllinois | — | $978.09 |
| IndianaIndiana | — | $817.92 |
| KansasKansas | — | $812.57 |
| KentuckyKentucky | — | $848.15 |
| New Orleans, LALouisiana | — | $885.86 |
| Rest of LouisianaLouisiana | — | $851.12 |
| Metropolitan Boston, MAMassachusetts | — | $959.87 |
| Rest of MassachusettsMassachusetts | — | $895.07 |
| Baltimore area, MDMaryland | — | $944.31 |
| Rest of MarylandMaryland | — | $891.33 |
| Rest of MaineMaine | — | $829.07 |
| Southern Maine, MEMaine | — | $851.91 |
| Detroit, MIMichigan | — | $947.11 |
| Rest of MichiganMichigan | — | $876.52 |
| MinnesotaMinnesota | — | $830.87 |
| Metropolitan Kansas City, MOMissouri | — | $869.68 |
| Metropolitan St. Louis, MOMissouri | — | $876.15 |
| Rest of MissouriMissouri | — | $845.58 |
| MississippiMississippi | — | $822.27 |
| MontanaMontana | — | $890.61 |
| North CarolinaNorth Carolina | — | $834.75 |
| North DakotaNorth Dakota | — | $832.67 |
| NebraskaNebraska | — | $806.11 |
| New HampshireNew Hampshire | — | $891.25 |
| Northern New JerseyNew Jersey | — | $977.41 |
| Rest of New JerseyNew Jersey | — | $948.10 |
| New MexicoNew Mexico | — | $884.80 |
| NevadaNevada | — | $874.77 |
| NYC suburbs and Long Island, NYNew York | — | $1,064.08 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $962.50 |
| Queens, NYNew York | — | $1,021.30 |
| Rest of New YorkNew York | — | $846.27 |
| OhioOhio | — | $864.68 |
| OklahomaOklahoma | — | $835.88 |
| Portland, OROregon | — | $907.82 |
| Rest of OregonOregon | — | $860.50 |
| Metropolitan Philadelphia, PAPennsylvania | — | $931.08 |
| Rest of PennsylvaniaPennsylvania | — | $860.06 |
| Puerto RicoPuerto Rico | — | $892.74 |
| Rhode IslandRhode Island | — | $899.63 |
| South CarolinaSouth Carolina | — | $852.62 |
| South DakotaSouth Dakota | — | $825.82 |
| TennesseeTennessee | — | $817.35 |
| Austin, TXTexas | — | $898.55 |
| Beaumont, TXTexas | — | $856.02 |
| Brazoria, TXTexas | — | $870.36 |
| Dallas, TXTexas | — | $880.02 |
| Fort Worth, TXTexas | — | $878.20 |
| Galveston, TXTexas | — | $875.67 |
| Houston, TXTexas | — | $929.30 |
| Rest of TexasTexas | — | $865.54 |
| UtahUtah | — | $862.26 |
| VirginiaVirginia | — | $856.77 |
| Virgin Islands, VIUnited States Virgin Islands | — | $892.74 |
| VermontVermont | — | $839.36 |
| Rest of WashingtonWashington | — | $890.09 |
| King County, WAWashington | — | $967.28 |
| WisconsinWisconsin | — | $810.09 |
| West VirginiaWest Virginia | — | $892.46 |
| WyomingWyoming | — | $865.36 |
45541 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 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.
How the rate is built · 45541
RVUs × geographic indexes × conversion factor
Work14.48
14.48 RVUs× 1.000 GPCI
Practice expense9.26
9.26 RVUs× 1.000 GPCI
Malpractice2.93
2.93 RVUs× 1.000 GPCI
Adjusted RVUs
26.6700
Conversion factor
$33.4009
Medicare rate
$890.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Delaware inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,545
- Code
- 45541
- Physician work
- 14.48
- Practice expense
- 9.26
- Malpractice
- 2.93
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.48 | × 1.005 | 14.5524 |
| Practice expense | 9.26 | × 0.988 | 9.1489 |
| Malpractice | 2.93 | × 0.899 | 2.6341 |
| Total RVUs | 26.3353 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$879.62
Facility: (14.48 × 1.005 + 9.26 × 0.988 + 2.93 × 0.899) × $33.4009 = $879.62
Payment rules and modifiers for 45541
45541 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45541
Prolapse repair, perineal 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) | 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 · 45541
Prolapse repair, perineal 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
45541 without 51 · national facility
$890.80
Prolapse repair, perineal approach
45541-51 · Second procedure: 50%
$445.40
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 45541 has changed in Delaware
45541 · 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 | $879.62 | RVU26D |
| 2026-07-01 | Not available in this setting | $879.62 | RVU26C |
| 2026-04-01 | Not available in this setting | $879.62 | RVU26B |
| 2026-01-01 | Not available in this setting | $879.62 | RVU26A |
| 2025-10-01 | Not available in this setting | $913.25 | RVU25D |
| 2025-07-01 | Not available in this setting | $913.25 | RVU25C |
| 2025-04-01 | Not available in this setting | $913.25 | RVU25B |
| 2025-01-01 | Not available in this setting | $913.25 | RVU25A |
| 2024-10-01 | Not available in this setting | $932.58 | RVU24D |
| 2024-07-01 | Not available in this setting | $932.58 | RVU24C |
| 2024-04-01 | Not available in this setting | $932.58 | RVU24B |
| 2024-03-09 | Not available in this setting | $932.58 | RVU24AR |
| 2024-01-01 | Not available in this setting | $917.36 | RVU24A |
| 2023-10-01 | Not available in this setting | $949.03 | RVU23D |
| 2023-07-01 | Not available in this setting | $949.03 | RVU23C |
| 2023-04-01 | Not available in this setting | $949.03 | RVU23B |
| 2023-01-01 | Not available in this setting | $949.03 | RVU23A |
| 2022-10-01 | Not available in this setting | $974.21 | RVU22D |
| 2022-07-01 | Not available in this setting | $974.21 | RVU22C |
| 2022-04-01 | Not available in this setting | $974.21 | RVU22B |
| 2022-01-01 | Not available in this setting | $974.21 | RVU22A |
| 2021-10-01 | Not available in this setting | $975.29 | RVU21D |
| 2021-07-01 | Not available in this setting | $975.29 | RVU21C |
| 2021-04-01 | Not available in this setting | $975.29 | RVU21B |
| 2021-01-01 | Not available in this setting | $975.29 | RVU21A |
| 2020-10-01 | Not available in this setting | $999.94 | RVU20D |
| 2020-07-01 | Not available in this setting | $999.94 | RVU20C |
| 2020-04-01 | Not available in this setting | $999.94 | RVU20B |
| 2020-01-01 | Not available in this setting | $999.94 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,007.84 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,007.84 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,007.84 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,007.84 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,003.83 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,003.83 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,003.83 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,003.83 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,004.87 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,004.87 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,004.87 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,004.87 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,003.37 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,003.37 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,003.37 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,003.37 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,000.90 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,000.90 | RVU15C |
| 2015-04-01 | Not available in this setting | $995.92 | RVU15B |
| 2015-01-01 | Not available in this setting | $995.92 | RVU15A |
| 2014-10-01 | Not available in this setting | $960.68 | RVU14D |
| 2014-07-01 | Not available in this setting | $960.68 | RVU14C |
| 2014-04-01 | Not available in this setting | $960.68 | RVU14B |
| 2014-01-01 | Not available in this setting | $960.68 | RVU14A |
| 2013-10-01 | Not available in this setting | $935.31 | RVU13D |
| 2013-07-01 | Not available in this setting | $935.31 | RVU13C |
| 2013-04-01 | Not available in this setting | $935.31 | RVU13B |
| 2013-01-01 | Not available in this setting | $935.31 | RVU13AR |
Where the Delaware rate applies
Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.
- Arden
- Ardencroft
- Ardentown
- Bear
- Bellefonte
- Bethany Beach
- Bethel
- Blades
45541 billing questions
How is 45541 distinguished from 45540?
45541 is for correction through a perineal route. Use 45540 for an abdominal approach to rectal prolapse.
Does a Delorme-type repair fit 45541?
Yes, a Delorme-type perineal repair is a representative procedure. The operative note should establish the perineal approach and the corrective work performed.
Is modifier 50 appropriate?
No. The anatomy and service descriptor make modifier 50 inappropriate for this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple-procedure reduction.
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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