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Billing code 45000: Pelvic abscess drainageMedicare rate & RVUs

Reports operative drainage of a pelvic abscess approached through the rectum, when the abscess location and route match this procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities134 Medicare services in 2024

Medicare pays $412.84 for 45000 nationally in a facility.

Medicare rate · 45000

Pelvic abscess drainage

Swap in your local Medicare rate.

Work RVUs
6.14
Total RVUs
12.36
Global days
090

National rate · 2026

$412.84

Facility setting, before claim adjustments.

See every locality for 45000 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 45000 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 45000 covers

billing code 45000 represents surgical drainage of an abscess located in the pelvis using a transrectal approach. A colorectal or general surgeon may perform it in an operating room when the pelvic collection is reached through the rectum. The key distinction is the pelvic location of the abscess, rather than a collection confined to the rectal wall or perirectal tissues.

Select the code based on the documented abscess location and operative route. The note should identify the pelvic collection and describe drainage through the rectum. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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.

Where 45000 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

45000 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$375.20
Alaska*Unavailable$509.48
ArizonaUnavailable$402.13
ArkansasUnavailable$370.56
AtlantaUnavailable$423.76
AustinUnavailable$418.80
BakersfieldUnavailable$418.30
Baltimore/Surr. CntysUnavailable$437.47
BeaumontUnavailable$394.85
BrazoriaUnavailable$404.64

45000 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
45000 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 45000 rate is calculated

Each of 45000’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 · 45000

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.14Practice expense 5.09Malpractice 1.13

12.3600 adjusted RVUs×$33.4009 conversion factor=$412.84

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 45000

45000 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45000

Pelvic abscess drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 45000

Pelvic abscess drainage

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45000 without 51 · national facility

$412.84

Pelvic abscess drainage

45000-51 · Second procedure: 50%

$206.42

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

45000 compared with similar codes

Compare codes

45000 vs 45005 vs 45020 vs 49407: national Medicare rates

Swap in your local Medicare rate.

  • 45000
    Pelvic abscess drainage · 6.14 wRVU
    —
  • 45005
    Rectal abscess drainage · 1.97 wRVU
    $366.74
  • 45020
    Abscess drainage · 8.35 wRVU
    —
  • 49407
    Pelvic drainage · 4.14 wRVU
    $736.82

How to choose

45005Rectal abscess drainage
45000 is for a pelvic abscess drained transrectally. 45005 is for an abscess located in the rectal area and treated by a transanal approach.
45020Abscess drainage
Choose 45020 for perirectal abscess drainage through a transperineal route. 45000 describes transrectal drainage of a pelvic abscess.
49407Pelvic drainage
49407 describes image-guided catheter drainage by a transrectal or transvaginal route. 45000 is the operative drainage code for a pelvic abscess approached transrectally.

Codes related to 45000

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

Codes related to 45000
CodeHow it relatesNational office range
Same family
45005Rectal abscess drainageRelated abscess drainage code for a rectal rather than pelvic collection.$318.45–$491.56
45020Abscess drainageRelated drainage code for a perirectal abscess approached transperineally.No office rate
Used instead
49407Pelvic drainageImage-guided catheter drainage by a transrectal or transvaginal route.$646.57–$1,001.16

45000 billing questions

How is 45000 distinguished from drainage of a rectal abscess?

Use 45000 when the abscess is pelvic and the operative route is transrectal. A collection confined to the rectum or perirectal tissues points to a different drainage code.

What documentation supports reporting 45000?

Document the pelvic abscess and the transrectal route used to drain it. The operative report should make clear that the target was pelvic, not a rectal or perirectal abscess.

Does the 90-day global period include postoperative care?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can modifier 50 be reported for bilateral drainage?

No. Modifier 50 is inappropriate for this code; report the service for the pelvic drainage rather than as a bilateral procedure.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures performed in that session are paid at 50%. Medicare does not pay an assistant at surgery for 45000.

Can co-surgeons or a surgical team be reported?

No. Medicare does not permit co-surgeons or team surgery for this service.

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 45000PPRRVU2026_Oct_nonQPP.csv, line 5,459 (RVU26D)

Open CMS sourceHow we calculate rates

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