CPT 45123: Partial proctectomyMedicare rate & RVUs

Medicare pays $1,032.76 for 45123 nationally in a facility.

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

What 45123 covers

A partial proctectomy removes a portion of the rectum as definitive surgery. Colorectal and general surgeons typically perform it in a hospital operating room for rectal disease that requires removal of rectal tissue, such as a malignancy or another condition requiring resection. The operative report should establish the extent of rectum removed and distinguish the resection from a biopsy or localized excision of a rectal lesion.

Select this code when the documented operation is a partial proctectomy; use a more specific neighboring code when the operative details meet that code’s definition. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate for this anatomy and descriptor. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 45123 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

45123 rates by state

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

How the 45123 rate is calculated

Each of 45123’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 45123

45123 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

45123 compared with similar codes

How to choose

45111Partial proctectomy

Both are partial-proctectomy codes. Choose based on the exact operative service documented and the distinctions in the current CPT code set.

45113Partial proctectomy

This is another partial-proctectomy option. Do not choose between the codes from the brief descriptor alone; match the operative details to the full CPT definition.

45110Rectal resection

45110 represents complete rectal removal, while 45123 is for partial removal.

45160Rectal lesion excision

45160 describes excision of a rectal lesion; 45123 is for a partial proctectomy, a broader rectal resection.

Codes related to 45123

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

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