CPT code 45990: Anorectal exam, diagnostic, under anesthesia2026 Medicare rate & RVUs in Delaware

In Delaware, Medicare pays $98.30 for 45990 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 45990 nationwide

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

What 45990 covers

This service is a diagnostic examination of the anal canal and distal rectum performed under anesthesia, typically by a colorectal or general surgeon in an operating room or other procedural setting. It is useful when pain, sphincter spasm, or inability to tolerate positioning prevents a reliable office assessment—for example, when evaluating persistent anorectal pain, bleeding, or a suspected lesion. The code represents the diagnostic examination, not treatment of a prolapse, narrowing, or obstruction.

Report it when the record supports why an examination under anesthesia was needed, what areas and findings were assessed, and the diagnostic purpose. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery, co-surgeon, and team-surgery payment requires documentation supporting medical necessity.

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 Delaware compares for 45990

Across 109 of 109 payment localities, the facility rate for 45990 runs from $89.77 in Arkansas to $125.57 in Alaska. Delaware pays $98.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

45990 rates by state

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

See 45990 in every payment locality

How the 45990 rate is calculated

Each of 45990’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.

Payment rules and modifiers for 45990

The CMS indicators that decide how 45990 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 45990

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

How 45990 has changed in Delaware

Price 45990 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

• Arden
• Ardencroft
• Ardentown
• Bear
• Bellefonte
• Bethany Beach
• Bethel
• Blades

Browse all communities in Delaware

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

Open CMS sourceHow we calculate rates