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CPT code 45116: Partial proctectomy2026 Medicare rate & RVUs

Reports partial rectal removal through a transsacral approach with anastomosis when the surgeon documents this specific operative route and reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,406.85 for 45116 nationally in a facility.

Medicare rate · 45116

Partial proctectomy

Work RVUs
27.03
Total RVUs
42.12
Global days
090

National rate · 2026

$1,406.85

Facility setting, before claim adjustments.

See every locality for 45116 →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 45116 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 45116 covers

This service removes part of the rectum through a posterior route that accesses the rectum via the sacral or coccygeal area, then reconnects the remaining bowel. A colorectal or general surgeon may perform it for selected rectal conditions when this approach is chosen; the operative report should establish the extent of rectal resection and the route used. It is distinct from partial proctectomy performed through an abdominal, perineal, or transanal approach.

Select the code from the documented procedure and approach, not from the diagnosis alone. The operative report should describe the resection, transsacral access, and anastomosis. CMS assigns major-surgery status with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted for this code.

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 45116 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

45116 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,303.70
Alaska*Unavailable$1,824.24
ArizonaUnavailable$1,376.54
ArkansasUnavailable$1,291.08
AtlantaUnavailable$1,441.66
AustinUnavailable$1,415.54
BakersfieldUnavailable$1,409.11
Baltimore/Surr. CntysUnavailable$1,479.39
BeaumontUnavailable$1,363.95
BrazoriaUnavailable$1,382.12

45116 rates by state

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

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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
45116 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 45116 rate is calculated

Each of 45116’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 · 45116

RVUs × geographic indexes × conversion factor

Work27.03

27.03 RVUs× 1.000 GPCI

Practice expense11.20

11.20 RVUs× 1.000 GPCI

Malpractice3.89

3.89 RVUs× 1.000 GPCI

Adjusted RVUs

42.1200

Conversion factor

$33.4009

Medicare rate

$1,406.85

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

Payment rules and modifiers for 45116

45116 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45116

Partial proctectomy

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 45116

Partial proctectomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

45116 without 51 · national facility

$1,406.85

Partial proctectomy

45116-51 · Second procedure: 50%

$703.43

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

45116 compared with similar codes

Compare codes · National

5 codes, side by side

  • 45116

    Partial proctectomy27.03 wRVU

    Not priced

  • 45111

    Partial proctectomy17.56 wRVU

    Not priced

  • 45112

    Rectal removal32.35 wRVU

    Not priced

  • 45113

    Partial proctectomy32.39 wRVU

    Not priced

  • 45110

    Rectal resection29.99 wRVU

    Not priced

How to choose

45111Partial proctectomy
Choose 45116 for the transsacral route. Code 45111 represents partial proctectomy through a different approach.
45112Rectal removal
Choose 45116 when the operative report documents transsacral access; 45112 is the perineal-approach sibling.
45113Partial proctectomy
Choose 45116 for a transsacral operation, not a transanal approach as represented by 45113.
45110Rectal resection
45116 represents partial rectal removal with anastomosis. Code 45110 is for complete rectal removal.

Codes related to 45116

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

Codes related to 45116
CodeHow it relatesNational office range
Same family
45111Partial proctectomyPartial proctectomy sibling distinguished by its operative approach.No office rate
45112Rectal removalPartial proctectomy sibling using a perineal approach.No office rate
45113Partial proctectomyPartial proctectomy sibling using a transanal approach.No office rate
Used instead
45110Rectal resectionConsider when the operation removes the rectum completely rather than partially.No office rate
45119ProctectomyRelated partial proctectomy with a colonic reservoir reconstruction.No office rate

45116 billing questions

Is the anastomosis reported separately?

The anastomosis is part of the partial proctectomy service represented here; the code selection should reflect the documented resection and reconstruction.

What documentation supports this code?

The operative report should identify the partial rectal resection, the transsacral route, and the anastomosis. The diagnosis alone does not establish the approach.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted for this code.

How are other same-session procedures handled?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to other procedures performed in the same session.

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 45116PPRRVU2026_Oct_nonQPP.csv, line 5,471 (RVU26D)

Open CMS sourceHow we calculate rates

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