CPT code 45563: Rectal repair, with colostomy2026 Medicare rate & RVUs in Metropolitan Kansas City, MO
Reports operative exploration and repair of the rectum performed with colostomy creation, such as in selected congenital rectal conditions or rectal injuries.
In Metropolitan Kansas City, MO, Medicare pays $1,535.19 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.
On this page 11 sections
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 Metropolitan Kansas City, MO 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. Metropolitan Kansas City, MO pays $1,535.19. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Metropolitan Kansas City, MO · this page$1,535.19
- Metropolitan St. Louis, MO · Missouri$1,547.18+$11.99
- Rest of Missouri · Missouri$1,497.42−$37.77
- Los Angeles, CA · California$1,616.22+$81.03
- Washington, DC area · District of Columbia$1,727.86+$192.67
- Miami, FL · Florida$1,939.93+$404.74
- Chicago, IL · Illinois$1,874.99+$339.80
Other areas in Missouri first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NYNew York | — | $1,837.12 |
| AlaskaAlaska | — | $1,927.81 |
| AlabamaAlabama | — | $1,410.19 |
| ArkansasArkansas | — | $1,390.80 |
| ArizonaArizona | — | $1,521.92 |
| Bakersfield, CACalifornia | — | $1,542.81 |
| Chico, CACalifornia | — | $1,524.37 |
| El Centro, CACalifornia | — | $1,525.51 |
| Fresno, CACalifornia | — | $1,524.37 |
| Hanford, CACalifornia | — | $1,524.37 |
| Madera, CACalifornia | — | $1,524.37 |
| Merced, CACalifornia | — | $1,524.37 |
| Modesto, CACalifornia | — | $1,524.37 |
| Napa, CACalifornia | — | $1,664.39 |
| Oxnard, CACalifornia | — | $1,595.17 |
| Redding, CACalifornia | — | $1,524.37 |
| Rest of CaliforniaCalifornia | — | $1,524.37 |
| Riverside, CACalifornia | — | $1,597.86 |
| Sacramento, CACalifornia | — | $1,572.96 |
| Salinas, CACalifornia | — | $1,566.74 |
| San Diego, CACalifornia | — | $1,585.07 |
| Marin County, CACalifornia | — | $1,724.97 |
| San Francisco, CACalifornia | — | $1,717.18 |
| San Benito County, CACalifornia | — | $1,770.91 |
| Santa Clara County, CACalifornia | — | $1,739.06 |
| San Luis Obispo, CACalifornia | — | $1,545.08 |
| Santa Cruz, CACalifornia | — | $1,585.12 |
| Santa Maria, CACalifornia | — | $1,567.53 |
| Santa Rosa, CACalifornia | — | $1,599.11 |
| Stockton, CACalifornia | — | $1,524.37 |
| Vallejo, CACalifornia | — | $1,653.17 |
| Visalia, CACalifornia | — | $1,524.37 |
| Yuba City, CACalifornia | — | $1,524.37 |
| ColoradoColorado | — | $1,560.80 |
| ConnecticutConnecticut | — | $1,672.23 |
| DelawareDelaware | — | $1,545.22 |
| Fort Lauderdale, FLFlorida | — | $1,761.24 |
| Rest of FloridaFlorida | — | $1,663.90 |
| Atlanta, GAGeorgia | — | $1,626.18 |
| Rest of GeorgiaGeorgia | — | $1,561.82 |
| Hawaii, Guam, HIHawaii | — | $1,539.36 |
| IowaIowa | — | $1,390.74 |
| IdahoIdaho | — | $1,410.56 |
| East St. Louis, ILIllinois | — | $1,763.65 |
| Rest of IllinoisIllinois | — | $1,656.94 |
| Suburban Chicago, ILIllinois | — | $1,765.75 |
| IndianaIndiana | — | $1,416.91 |
| KansasKansas | — | $1,409.96 |
| KentuckyKentucky | — | $1,496.90 |
| New Orleans, LALouisiana | — | $1,572.59 |
| Rest of LouisianaLouisiana | — | $1,504.83 |
| Metropolitan Boston, MAMassachusetts | — | $1,673.30 |
| Rest of MassachusettsMassachusetts | — | $1,562.60 |
| Baltimore area, MDMaryland | — | $1,673.05 |
| Rest of MarylandMaryland | — | $1,565.42 |
| Rest of MaineMaine | — | $1,444.70 |
| Southern Maine, MEMaine | — | $1,480.96 |
| Detroit, MIMichigan | — | $1,710.17 |
| Rest of MichiganMichigan | — | $1,557.50 |
| MinnesotaMinnesota | — | $1,422.50 |
| MississippiMississippi | — | $1,443.09 |
| MontanaMontana | — | $1,569.38 |
| North CarolinaNorth Carolina | — | $1,454.86 |
| North DakotaNorth Dakota | — | $1,433.74 |
| NebraskaNebraska | — | $1,390.24 |
| New HampshireNew Hampshire | — | $1,560.95 |
| Northern New JerseyNew Jersey | — | $1,716.61 |
| Rest of New JerseyNew Jersey | — | $1,670.74 |
| New MexicoNew Mexico | — | $1,575.92 |
| NevadaNevada | — | $1,532.06 |
| NYC suburbs and Long Island, NYNew York | — | $1,912.22 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,702.37 |
| Queens, NYNew York | — | $1,813.76 |
| Rest of New YorkNew York | — | $1,477.71 |
| OhioOhio | — | $1,529.77 |
| OklahomaOklahoma | — | $1,467.21 |
| Portland, OROregon | — | $1,578.39 |
| Rest of OregonOregon | — | $1,499.86 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,649.27 |
| Rest of PennsylvaniaPennsylvania | — | $1,517.75 |
| Puerto RicoPuerto Rico | — | $1,571.70 |
| Rhode IslandRhode Island | — | $1,577.31 |
| South CarolinaSouth Carolina | — | $1,498.87 |
| South DakotaSouth Dakota | — | $1,417.70 |
| TennesseeTennessee | — | $1,419.93 |
| Austin, TXTexas | — | $1,573.37 |
| Beaumont, TXTexas | — | $1,510.23 |
| Brazoria, TXTexas | — | $1,521.97 |
| Dallas, TXTexas | — | $1,543.11 |
| Fort Worth, TXTexas | — | $1,541.27 |
| Galveston, TXTexas | — | $1,533.93 |
| Houston, TXTexas | — | $1,659.50 |
| Rest of TexasTexas | — | $1,523.05 |
| UtahUtah | — | $1,517.57 |
| VirginiaVirginia | — | $1,494.29 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,571.70 |
| VermontVermont | — | $1,451.84 |
| Rest of WashingtonWashington | — | $1,551.78 |
| King County, WAWashington | — | $1,680.20 |
| WisconsinWisconsin | — | $1,391.06 |
| West VirginiaWest Virginia | — | $1,605.50 |
| WyomingWyoming | — | $1,510.27 |
45563 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 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.
How the rate is built · 45563
RVUs × geographic indexes × conversion factor
Work25.72
25.72 RVUs× 1.000 GPCI
Practice expense14.42
14.42 RVUs× 1.000 GPCI
Malpractice6.86
6.86 RVUs× 1.000 GPCI
Adjusted RVUs
47.0000
Conversion factor
$33.4009
Medicare rate
$1,569.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Metropolitan Kansas City, MO inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,551
- Code
- 45563
- Physician work
- 25.72
- Practice expense
- 14.42
- Malpractice
- 6.86
GPCI2026.csv
68
- Locality
- Metropolitan Kansas City, MO
- Physician work
- 1.000
- Practice expense
- 0.939
- Malpractice
- 0.977
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.72 | × 1.000 | 25.7200 |
| Practice expense | 14.42 | × 0.939 | 13.5404 |
| Malpractice | 6.86 | × 0.977 | 6.7022 |
| Total RVUs | 45.9626 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Metropolitan Kansas City, MO$1535.19
Facility: (25.72 × 1 + 14.42 × 0.939 + 6.86 × 0.977) × $33.4009 = $1535.19
Payment rules and modifiers for 45563
45563 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45563
Rectal repair, with colostomy
| 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 · 45563
Rectal repair, with colostomy
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
45563 without 51 · national facility
$1,569.84
Rectal repair, with colostomy
45563-51 · Second procedure: 50%
$784.92
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 45563 has changed in Metropolitan Kansas City, MO
45563 · 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 | $1,535.19 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,535.19 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,535.19 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,535.19 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,585.93 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,585.93 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,585.93 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,585.93 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,623.34 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,623.34 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,623.34 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,623.34 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,596.84 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,638.63 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,638.63 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,638.63 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,638.63 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,666.67 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,666.67 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,666.67 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,666.67 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,667.97 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,667.97 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,667.97 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,667.97 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,716.01 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,716.01 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,716.01 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,716.01 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,725.34 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,725.34 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,716.06 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,716.06 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,717.40 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,717.40 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,717.40 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,717.40 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,693.52 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,693.52 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,693.52 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,693.52 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,691.94 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,691.94 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,691.94 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,691.94 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,695.20 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,695.20 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,686.77 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,686.77 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,676.39 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,676.39 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,676.39 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,676.39 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,677.46 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,677.46 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,677.46 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,677.46 | RVU13AR |
Where the Metropolitan Kansas City, MO rate applies
Metropolitan Kansas City, MO is a Medicare payment area, not a city. Our Census mapping connects it to 62 cities and communities in Missouri. Some span more than one payment area; confirm with the service ZIP.
45563 billing questions
How is 45563 distinguished from 45562?
45563 describes rectal exploration and repair performed with colostomy creation. Use 45562 when exploration and repair are performed without the colostomy component described by 45563.
Can the colostomy be reported separately?
The colostomy is part of the service described by 45563. Review the operative report to confirm that both the rectal work and colostomy creation were performed.
What documentation supports 45563?
The operative report should describe the rectal exploration, the repair performed, and creation of the colostomy. Include the clinical condition and relevant operative findings.
Can modifier 50 be used?
No. Report the rectal operation as a single procedure; modifier 50 is inappropriate for this service.
How are other same-session procedures handled?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.
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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