CPT code 45900: Prolapse reduction, under anesthesia2026 Medicare rate & RVUs in New Jersey
Reports reduction of a rectal prolapse performed under anesthesia, typically when the prolapsed tissue requires reduction in an operative or procedural setting.
CMS doesn’t publish an office rate for 45900 in New Jersey.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | Unavailable | $233.37 |
| Rest of New Jersey | Unavailable | $225.94 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
45900 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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