CPT code 45563: Rectal repair, with colostomy2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $1,727.86 for 45563 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 45563 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 45563 covers

A colorectal or general surgeon uses this service when operative exploration and rectal repair are performed together with creation of a colostomy. A congenital anorectal condition, such as imperforate anus, is a representative clinical context; the exact operative plan depends on the anatomy and findings. This is generally an operating-room service rather than an office procedure.

Report the code when the operative record supports both rectal exploration and repair and colostomy creation as part of the operation. The 90-day global package includes the day-before preoperative visit and related postoperative care through day 90. 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% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted. Report this as a single rectal operation, not a bilateral procedure using modifier 50.

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 Washington, DC area compares for 45563

Across 109 of 109 payment localities, the facility rate for 45563 runs from $1,390.24 in Nebraska to $1,939.93 in Miami, FL. Washington, DC area pays $1,727.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

45563 rates by state

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

See 45563 in every payment locality

How the 45563 rate is calculated

Each of 45563’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 45563

45563 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

Codes related to 45563

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

How 45563 has changed in Washington, DC area

Price 45563 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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