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CPT code 45900: Prolapse reduction, under anesthesia2026 Medicare rate & RVUs

Reports reduction of a rectal prolapse performed under anesthesia, typically when the prolapsed tissue requires reduction in an operative or procedural setting.

CMS RVU26DEffective Oct 1, 2026109 payment localities87 Medicare services in 2024

Medicare pays $211.43 for 45900 nationally in a facility.

Medicare rate · 45900

Prolapse reduction, under anesthesia

Office or facility?

Work RVUs
2.92
Total RVUs
6.33
Global days
010

National rate · 2026

$211.43

Facility setting, before claim adjustments.

See every locality for 45900 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 45900 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 45900 covers

This service covers reducing prolapsed rectal tissue while the patient is under anesthesia. A surgeon or other qualified physician may perform it in an operating room or procedural setting when the prolapse needs reduction under anesthesia. It describes reduction, not definitive surgical repair of the prolapse.

Report the service when documentation supports both the rectal prolapse and its reduction under anesthesia. The procedure has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, CMS pays the highest-valued procedure in full and reduces payment for the others by the standard multiple-procedure rule. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment 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.

Where 45900 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

45900 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$189.04
AlaskaUnavailable$254.03
ArizonaUnavailable$204.92
ArkansasUnavailable$186.29
Atlanta, GAUnavailable$218.42
Austin, TXUnavailable$213.69
Bakersfield, CAUnavailable$211.36
Baltimore area, MDUnavailable$225.63
Beaumont, TXUnavailable$201.68
Brazoria, TXUnavailable$205.62

45900 rates by state

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

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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
45900 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 45900 rate is calculated

Each of 45900’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 · 45900

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.92

2.92 RVUs× 1.000 GPCI

Practice expense2.62

2.62 RVUs× 1.000 GPCI

Malpractice0.79

0.79 RVUs× 1.000 GPCI

Adjusted RVUs

6.3300

Conversion factor

$33.4009

Medicare rate

$211.43

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 45900

45900 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45900

Prolapse reduction, under anesthesia

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 45900

Prolapse reduction, under anesthesia

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45900 without 51 · national facility

$211.43

Prolapse reduction, under anesthesia

45900-51 · Second procedure: 50%

$105.72

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%).

When to use modifier 51

45900 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 45900

    Prolapse reduction, under anesthesia2.92 wRVU

    Not priced

  • 45905

    Anal dilation, anal sphincter2.29 wRVU

    Not priced

  • 45910

    Rectal dilation, under anesthesia2.78 wRVU

    Not priced

  • 45915

    Rectal obstruction removal, under anesthesia3.11 wRVU

    $403.48

How to choose

45905Anal dilationAnal sphincter
This code concerns dilation of the anal sphincter; 45900 concerns reduction of rectal prolapse under anesthesia.
45910Rectal dilationUnder anesthesia
This code treats rectal narrowing by dilation. It is not the reduction service for prolapsed rectal tissue.
45915Rectal obstruction removalUnder anesthesia
This code addresses removal of a rectal obstruction, not reduction of rectal prolapse.

Codes related to 45900

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

Codes related to 45900
CodeHow it relatesNational office range
Used instead
45540Rectal prolapse repair, abdominal approachAbdominal rectopexy is a definitive operative approach for rectal prolapse rather than reduction under anesthesia.No office rate
45130Rectal prolapse repair, perineal mucosal excisionPerineal proctectomy is a definitive operative treatment option for rectal prolapse.No office rate
45990Anorectal exam, diagnostic, under anesthesiaUse for a diagnostic anorectal examination under anesthesia when examination, rather than prolapse reduction, is performed.No office rate

45900 billing questions

Does this code describe definitive repair of rectal prolapse?

No. It describes reduction under anesthesia. A definitive operation such as abdominal rectopexy or perineal proctectomy is a different service.

What documentation supports reporting the service?

Document the rectal prolapse, that the patient was under anesthesia, and the reduction performed. The record should distinguish reduction from definitive repair.

Can modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when the record supports medical necessity. CMS does not permit co-surgeon or team-surgery payment for this service.

Are postoperative visits separately included?

Related postoperative visits during the 10-day global period are included in the procedure's payment.

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
RVUs for 45900PPRRVU2026_Oct_nonQPP.csv, line 5,564 (RVU26D)

Open CMS sourceHow we calculate rates

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