FeeBase
Log inGet started
Menu

CPT code 45915: Rectal obstruction removal, under anesthesia2026 Medicare rate & RVUs in Alabama

Report this service when a clinician removes obstructing stool or a foreign body from the rectum under anesthesia.

CMS RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In Alabama, Medicare pays $359.63 for 45915 in the office and $209.41 when it’s performed in a hospital or facility.

$359.63Office (non-facility)
$209.41Hospital or facility
−10.9%vs the national office rate ($403.48)

Check a contract rate as a % of Medicare · 45915 nationwide

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

We’ll open 45915 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 45915 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 45915 covers

This service covers removal of obstructing material from the rectum when the work is performed under anesthesia. Typical cases include a substantial fecal impaction or a rectal foreign body that requires procedural extraction rather than routine office or bedside care. Colorectal and general surgeons commonly perform it in a hospital or ambulatory surgical setting; the clinical record should identify the obstruction and describe the removal performed.

Select the code for the extraction itself, not for treatment of a narrowing, sphincter problem, or prolapse that may cause obstructive symptoms. Document the material removed, the anatomic site, the technique, and the use of anesthesia. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code; assistant-at-surgery payment is restricted, and co-surgeons and team surgery 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.

How Alabama compares for 45915

Across 109 of 109 payment localities, the office rate for 45915 runs from $354.11 in Arkansas to $528.57 in San Benito County, CA. Alabama pays $359.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

45915 in Alabama vs other payment areas
  1. Alabama · this page$359.63
  2. Los Angeles, CA · California$451.82+$92.19
  3. Washington, DC area · District of Columbia$461.08+$101.45
  4. Miami, FL · Florida$446.58+$86.95
  5. Chicago, IL · Illinois$432.42+$72.79
  6. Manhattan, NY · New York$467.45+$107.82
  7. Alaska · Alaska$464.25+$104.62

Other areas in Alabama first, then benchmark localities. Bars start at $0.

Every other payment area

45915 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$354.11$206.64
ArizonaArizona$391.86$225.50
Bakersfield, CACalifornia$424.13$235.97
Chico, CACalifornia$422.41$234.25
El Centro, CACalifornia$422.52$234.36
Fresno, CACalifornia$422.41$234.25
Hanford, CACalifornia$422.41$234.25
Madera, CACalifornia$422.41$234.25

45915 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$354.11

$475.49

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
45915 office rate range by state
State / territoryOffice rate rangeLocalities
AK$464.251
AL$359.631
AR$354.111
AZ$391.861
CA$422.41–$528.5729
CO$418.041
CT$431.381
DC$461.081
DE$398.561
FL$401.63–$446.583
GA$377.34–$412.422
GU$432.971
HI$432.971
IA$367.291
ID$370.261
IL$390.88–$432.424
IN$372.481
KS$366.441
KY$370.771
LA$370.54–$389.842
MA$415.72–$459.572
MD$406.17–$461.083
ME$373.34–$393.332
MI$381.89–$407.932
MN$396.991
MO$364.46–$390.143
MS$359.311
MT$403.441
NC$377.321
ND$391.181
NE$369.131
NH$412.331
NJ$435.31–$456.062
NM$384.501
NV$400.301
NY$383.39–$480.595
OH$379.381
OK$369.021
OR$396.22–$430.802
PA$379.47–$420.782
PR$406.241
RI$412.421
SC$379.181
SD$389.731
TN$368.521
TX$376.91–$417.518
UT$384.641
VA$392.65–$461.082
VI$406.241
VT$390.461
WA$414.67–$468.202
WI$377.441
WV$375.871
WY$398.101

See 45915 in every payment locality

How the 45915 rate is calculated

Each of 45915’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 · 45915

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.11

3.11 RVUs× 1.000 GPCI

Practice expense8.35

8.35 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

12.0800

Conversion factor

$33.4009

Medicare rate

$403.48

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

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,567

Code
45915
Physician work
3.11
Practice expense
8.35
Malpractice
0.62

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 45915 in Alabama
ComponentRVULocality factorAdjusted
Physician work3.11× 1.0003.1100
Practice expense8.35× 0.8757.3062
Malpractice0.62× 0.5660.3509
Total RVUs10.7672
Conversion factor× 33.4009

Office rate, Alabama$359.63

Office: (3.11 × 1 + 8.35 × 0.875 + 0.62 × 0.566) × $33.4009 = $359.63

Facility: (3.11 × 1 + 3.21 × 0.875 + 0.62 × 0.566) × $33.4009 = $209.41

Open 45915 in the RVU calculator

Payment rules and modifiers for 45915

45915 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45915

Rectal obstruction removal, 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)1Not paid (statutory restriction).
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 · 45915

Rectal obstruction removal, 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

45915 without 51 · national office

$403.48

Rectal obstruction removal, under anesthesia

45915-51 · Second procedure: 50%

$201.74

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

Codes related to 45915

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

Codes related to 45915
CodeHow it relatesOffice range, Alabama
Used instead
45910Rectal dilation, under anesthesiaUsed for dilation when a rectal narrowing, rather than retained material, is treated.No office rate
45905Anal dilation, anal sphincterAddresses anal sphincter dilation, not removal of rectal contents or a foreign body.No office rate
45900Prolapse reduction, under anesthesiaTreats rectal prolapse by reduction when prolapse, rather than retained material, is the problem.No office rate

How 45915 has changed in Alabama

45915 · Office / nonfacility

$359.63

Effective 2026-10-01

The base rate is $51.33 higher than on 2025-10-01, moving from $308.30 to $359.63 (16.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $308.30changed to$359.63

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.19 changed to 3.11
    • Practice expense RVU 6.90 changed to 8.35
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $315.53changed to$308.30

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.84 changed to 6.90

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $310.38changed to$315.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $326.31changed to$310.38

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.58 changed to 0.60
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575

  5. January 1, 2023

    RVU23A

    $341.21changed to$326.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.92 changed to 6.84
    • Malpractice RVU 0.57 changed to 0.58
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $342.79changed to$341.21

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.89 changed to 6.92
    • Malpractice RVU 0.56 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $326.86changed to$342.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.17 changed to 6.89
    • Malpractice RVU 0.54 changed to 0.56
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $316.46changed to$326.86

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.00 changed to 6.17
    • Malpractice RVU 0.51 changed to 0.54
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $313.05changed to$316.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.91 changed to 6.00
    • Malpractice RVU 0.50 changed to 0.51

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$313.05

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$359.63$209.41RVU26D
2026-07-01$359.63$209.41RVU26C
2026-04-01$359.63$209.41RVU26B
2026-01-01$359.63$209.41RVU26A
2025-10-01$308.30$203.73RVU25D
2025-07-01$308.30$203.73RVU25C
2025-04-01$308.30$203.73RVU25B
2025-01-01$308.30$203.73RVU25A
2024-10-01$315.53$207.34RVU24D
2024-07-01$315.53$207.34RVU24C
2024-04-01$315.53$207.34RVU24B
2024-03-09$315.53$207.34RVU24AR
2024-01-01$310.38$203.96RVU24A
2023-10-01$326.31$214.74RVU23D
2023-07-01$326.31$214.74RVU23C
2023-04-01$326.31$214.74RVU23B
2023-01-01$326.31$214.74RVU23A
2022-10-01$341.21$223.52RVU22D
2022-07-01$341.21$223.52RVU22C
2022-04-01$341.21$223.52RVU22B
2022-01-01$341.21$223.52RVU22A
2021-10-01$342.79$224.74RVU21D
2021-07-01$342.79$224.74RVU21C
2021-04-01$342.79$224.74RVU21B
2021-01-01$342.79$224.74RVU21A
2020-10-01$326.86$222.59RVU20D
2020-07-01$326.86$222.59RVU20C
2020-04-01$326.86$222.59RVU20B
2020-01-01$326.86$222.59RVU20A
2019-10-01$316.46$216.70RVU19D
2019-07-01$316.46$216.70RVU19C
2019-04-01$316.46$216.70RVU19B
2019-01-01$316.46$216.70RVU19A
2018-10-01$313.05$215.97RVU18D
2018-07-01$313.05$215.97RVU18C
2018-04-01$313.05$215.97RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 45915 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

45915 billing questions

When should this code be chosen instead of rectal dilation?

Use this code when the service removes obstructing material from the rectum. Code 45910 describes dilation of a rectal narrowing, rather than extraction.

Does the code include anesthesia?

The service is defined as being performed under anesthesia. Document the anesthesia and the extraction performed; this code does not represent a separately reported anesthesia service.

Can modifier 50 be used?

No. The code’s descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Related postoperative visits during the 10-day global period are included.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
RVUs for 45915PPRRVU2026_Oct_nonQPP.csv, line 5,567 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 45915 pays in Alabama?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 45915 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist