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

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 North Carolina, Medicare pays $377.32 for 45915 in the office and $217.14 when it’s performed in a hospital or facility.

$377.32Office (non-facility)
$217.14Hospital or facility
−6.5%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 North Carolina
  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 North Carolina 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. North Carolina pays $377.32. The RVUs are the same everywhere; the geographic indexes change the dollars.

45915 in North Carolina vs other payment areas
  1. North Carolina · this page$377.32
  2. Los Angeles, CA · California$451.82+$74.50
  3. Washington, DC area · District of Columbia$461.08+$83.76
  4. Miami, FL · Florida$446.58+$69.26
  5. Chicago, IL · Illinois$432.42+$55.10
  6. Manhattan, NY · New York$467.45+$90.13
  7. Alaska · Alaska$464.25+$86.93

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

Every other payment area

45915 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$359.63$209.41
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

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 45915 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.11× 1.0003.1100
Practice expense8.35× 0.9337.7906
Malpractice0.62× 0.6390.3962
Total RVUs11.2967
Conversion factor× 33.4009

Office rate, North Carolina$377.32

Office: (3.11 × 1 + 8.35 × 0.933 + 0.62 × 0.639) × $33.4009 = $377.32

Facility: (3.11 × 1 + 3.21 × 0.933 + 0.62 × 0.639) × $33.4009 = $217.14

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, North Carolina
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 North Carolina

45915 · Office / nonfacility

$377.32

Effective 2026-10-01

The base rate is $54.55 higher than on 2025-10-01, moving from $322.77 to $377.32 (16.9%).

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

    $322.77changed to$377.32

    • 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 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $330.31changed to$322.77

    • 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

    $324.92changed to$330.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $337.55changed to$324.92

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.58 changed to 0.60
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $348.78changed to$337.55

    • 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 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $350.42changed to$348.78

    • 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

    $336.96changed to$350.42

    • 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 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $329.05changed to$336.96

    • 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 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $325.43changed to$329.05

    • 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. January 1, 2018

    RVU18AR1

    $321.15changed to$325.43

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.80 changed to 5.91
    • Malpractice RVU 0.49 changed to 0.50
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $320.76changed to$321.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.79 changed to 5.80
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $322.31changed to$320.76

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.81 changed to 5.79
    • Malpractice RVU 0.49 changed to 0.50

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $320.71changed to$322.31

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $315.41changed to$320.71

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.65 changed to 5.81
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $319.84changed to$315.41

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.31 changed to 5.65
    • Malpractice RVU 0.52 changed to 0.50
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $319.84

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$377.32$217.14RVU26D
2026-07-01$377.32$217.14RVU26C
2026-04-01$377.32$217.14RVU26B
2026-01-01$377.32$217.14RVU26A
2025-10-01$322.77$211.34RVU25D
2025-07-01$322.77$211.34RVU25C
2025-04-01$322.77$211.34RVU25B
2025-01-01$322.77$211.34RVU25A
2024-10-01$330.31$215.02RVU24D
2024-07-01$330.31$215.02RVU24C
2024-04-01$330.31$215.02RVU24B
2024-03-09$330.31$215.02RVU24AR
2024-01-01$324.92$211.51RVU24A
2023-10-01$337.55$219.75RVU23D
2023-07-01$337.55$219.75RVU23C
2023-04-01$337.55$219.75RVU23B
2023-01-01$337.55$219.75RVU23A
2022-10-01$348.78$225.78RVU22D
2022-07-01$348.78$225.78RVU22C
2022-04-01$348.78$225.78RVU22B
2022-01-01$348.78$225.78RVU22A
2021-10-01$350.42$227.05RVU21D
2021-07-01$350.42$227.05RVU21C
2021-04-01$350.42$227.05RVU21B
2021-01-01$350.42$227.05RVU21A
2020-10-01$336.96$227.88RVU20D
2020-07-01$336.96$227.88RVU20C
2020-04-01$336.96$227.88RVU20B
2020-01-01$336.96$227.88RVU20A
2019-10-01$329.05$224.71RVU19D
2019-07-01$329.05$224.71RVU19C
2019-04-01$329.05$224.71RVU19B
2019-01-01$329.05$224.71RVU19A
2018-10-01$325.43$223.87RVU18D
2018-07-01$325.43$223.87RVU18C
2018-04-01$325.43$223.87RVU18B
2018-01-01$325.43$223.87RVU18AR1
2017-10-01$321.15$222.92RVU17D
2017-07-01$321.15$222.92RVU17C
2017-04-01$321.15$222.92RVU17B
2017-01-01$321.15$222.92RVU17A
2016-10-01$320.76$222.53RVU16D
2016-07-01$320.76$222.53RVU16C
2016-04-01$320.76$222.53RVU16B
2016-01-01$320.76$222.53RVU16A
2015-10-01$322.31$224.06RVU15D
2015-07-01$322.31$224.06RVU15C
2015-04-01$320.71$222.95RVU15B
2015-01-01$320.71$222.95RVU15A
2014-10-01$315.41$219.90RVU14D
2014-07-01$315.41$219.90RVU14C
2014-04-01$315.41$219.90RVU14B
2014-01-01$315.41$219.90RVU14A
2013-10-01$319.84$217.65RVU13D
2013-07-01$319.84$217.65RVU13C
2013-04-01$319.84$217.65RVU13B
2013-01-01$319.84$217.65RVU13AR

Price 45915 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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