No office rate
Choose 45541 for a perineal repair; choose 45540 for an abdominal repair.
On this page
CMS RVU26D · Effective 2026-10-01
45540 Rectal prolapse repair Medicare reimbursement rates
Reported for an abdominal operation that repairs rectal prolapse without the sigmoid resection included in a separate code. Compare 45540 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 45540?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 45540 pays more and less
Colorectal surgery
About 45540: Abdominal rectal prolapse repair
Reported for an abdominal operation that repairs rectal prolapse without the sigmoid resection included in a separate code.
A surgeon uses an abdominal approach to restore and support a prolapsing rectum, commonly by securing it within the pelvis as a rectopexy. The operation is performed for rectal prolapse and is typically done in a hospital operating room by a colorectal or general surgeon. The abdominal approach distinguishes this service from repair through the perineum and from laparoscopic rectopexy codes.
Select this code when the operative report documents an abdominal repair without sigmoid resection; use the separate resection code when sigmoid resection is part of the operation. The report should identify the prolapse, approach, repair performed, and any resection. 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 other procedures are subject to the standard 50% reduction. Report the repair once; modifier 50 is not appropriate. Assistant-at-surgery payment may be available, co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 45540
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.67 · 61%
- Practice expense (office) RVU8.32 · 29%
- Malpractice RVU3.18 · 11%
328
Medicare services in 2024 · #3926 by national volume
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.
45540 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
45550 includes sigmoid resection with the abdominal prolapse repair. 45540 describes the repair without that resection.
No office rate
45400 describes laparoscopic rectopexy without resection. 45540 describes the abdominal approach represented by its code.
No office rate
45402 describes laparoscopic rectopexy with resection; 45540 is the abdominal repair code without sigmoid resection.
See how rates vary across the country
45540 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 45540 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $893.47 |
| Alaska* | Office Unavailable | Facility $1239.77 |
| Arizona | Office Unavailable | Facility $950.39 |
| Arkansas | Office Unavailable | Facility $883.61 |
| Atlanta | Office Unavailable | Facility $1001.87 |
| Austin | Office Unavailable | Facility $979.49 |
| Bakersfield | Office Unavailable | Facility $970.67 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1029.21 |
| Beaumont | Office Unavailable | Facility $941.75 |
| Brazoria | Office Unavailable | Facility $953.16 |
| Chicago | Office Unavailable | Facility $1117.37 |
| Chico | Office Unavailable | Facility $961.73 |
| Colorado | Office Unavailable | Facility $975.91 |
| Connecticut | Office Unavailable | Facility $1029.81 |
| Dallas | Office Unavailable | Facility $963.42 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1067.64 |
| Delaware | Office Unavailable | Facility $963.19 |
| Detroit | Office Unavailable | Facility $1037.44 |
| East St. Louis | Office Unavailable | Facility $1059.77 |
| El Centro | Office Unavailable | Facility $962.26 |
| Fort Lauderdale | Office Unavailable | Facility $1063.74 |
| Fort Worth | Office Unavailable | Facility $962.02 |
| Fresno | Office Unavailable | Facility $961.73 |
| Galveston | Office Unavailable | Facility $958.81 |
| Hanford-Corcoran | Office Unavailable | Facility $961.73 |
| Hawaii, Guam | Office Unavailable | Facility $967.66 |
| Houston | Office Unavailable | Facility $1017.02 |
| Idaho | Office Unavailable | Facility $896.10 |
| Indiana | Office Unavailable | Facility $899.42 |
| Iowa | Office Unavailable | Facility $886.64 |
| Kansas | Office Unavailable | Facility $894.94 |
| Kentucky | Office Unavailable | Facility $934.43 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1013.67 |
| Madera | Office Unavailable | Facility $961.73 |
| Manhattan | Office Unavailable | Facility $1119.34 |
| Merced | Office Unavailable | Facility $961.73 |
| Metropolitan Boston | Office Unavailable | Facility $1040.73 |
| Metropolitan Kansas City | Office Unavailable | Facility $954.91 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1016.82 |
| Metropolitan St. Louis | Office Unavailable | Facility $961.18 |
| Miami | Office Unavailable | Facility $1148.10 |
| Minnesota | Office Unavailable | Facility $907.59 |
| Mississippi | Office Unavailable | Facility $907.95 |
| Modesto | Office Unavailable | Facility $961.73 |
| Montana** | Office Unavailable | Facility $974.09 |
| Napa | Office Unavailable | Facility $1047.60 |
| Nebraska | Office Unavailable | Facility $886.84 |
| Nevada** | Office Unavailable | Facility $956.84 |
| New Hampshire | Office Unavailable | Facility $972.42 |
| New Mexico | Office Unavailable | Facility $972.59 |
| New Orleans | Office Unavailable | Facility $972.35 |
| North Carolina | Office Unavailable | Facility $917.34 |
| North Dakota** | Office Unavailable | Facility $911.21 |
| Northern Nj | Office Unavailable | Facility $1063.17 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1155.63 |
| Ohio | Office Unavailable | Facility $950.98 |
| Oklahoma | Office Unavailable | Facility $920.88 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1001.36 |
| Portland | Office Unavailable | Facility $987.40 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1049.57 |
| Puerto Rico | Office Unavailable | Facility $975.77 |
| Queens | Office Unavailable | Facility $1109.60 |
| Redding | Office Unavailable | Facility $961.73 |
| Rest Of California | Office Unavailable | Facility $961.73 |
| Rest Of Florida | Office Unavailable | Facility $1015.50 |
| Rest Of Georgia | Office Unavailable | Facility $964.68 |
| Rest Of Illinois | Office Unavailable | Facility $1009.93 |
| Rest Of Louisiana | Office Unavailable | Facility $937.89 |
| Rest Of Maine | Office Unavailable | Facility $911.92 |
| Rest Of Maryland | Office Unavailable | Facility $974.83 |
| Rest Of Massachusetts | Office Unavailable | Facility $976.91 |
| Rest Of Michigan | Office Unavailable | Facility $963.83 |
| Rest Of Missouri | Office Unavailable | Facility $933.19 |
| Rest Of New Jersey | Office Unavailable | Facility $1033.78 |
| Rest Of New York | Office Unavailable | Facility $928.86 |
| Rest Of Oregon | Office Unavailable | Facility $941.65 |
| Rest Of Pennsylvania | Office Unavailable | Facility $945.68 |
| Rest Of Texas | Office Unavailable | Facility $949.83 |
| Rest Of Washington | Office Unavailable | Facility $971.32 |
| Rhode Island | Office Unavailable | Facility $983.22 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $995.99 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $991.56 |
| Salinas | Office Unavailable | Facility $987.50 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $997.83 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1086.85 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1083.24 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1112.77 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1098.01 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $973.68 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $997.16 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $987.68 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1006.09 |
| Seattle (King Cnty) | Office Unavailable | Facility $1047.46 |
| South Carolina | Office Unavailable | Facility $937.25 |
| South Dakota** | Office Unavailable | Facility $903.78 |
| Southern Maine | Office Unavailable | Facility $932.61 |
| Stockton | Office Unavailable | Facility $961.73 |
| Suburban Chicago | Office Unavailable | Facility $1067.94 |
| Tennessee | Office Unavailable | Facility $899.84 |
| Utah | Office Unavailable | Facility $946.80 |
| Vallejo | Office Unavailable | Facility $1042.39 |
| Vermont | Office Unavailable | Facility $919.06 |
| Virgin Islands | Office Unavailable | Facility $975.77 |
| Virginia | Office Unavailable | Facility $938.35 |
| Visalia | Office Unavailable | Facility $961.73 |
| West Virginia | Office Unavailable | Facility $983.68 |
| Wisconsin | Office Unavailable | Facility $889.13 |
| Wyoming** | Office Unavailable | Facility $946.69 |
| Yuba City | Office Unavailable | Facility $961.73 |
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45540 billing questions
How is 45540 distinguished from 45550?
45540 describes abdominal repair without sigmoid resection. When the abdominal prolapse repair includes sigmoid resection, use 45550.
When should 45541 be reported instead?
45541 describes repair through a perineal approach. Use 45540 when the surgeon repairs the prolapse through an abdominal approach.
Does 45540 describe laparoscopic rectopexy?
No. Laparoscopic rectopexy is described by 45400 without resection or 45402 with resection; 45540 is for the abdominal approach represented by that code.
What operative documentation supports 45540?
Document the rectal prolapse, the abdominal approach, and the repair performed. State whether sigmoid resection was performed so the applicable repair code can be selected.
How does the global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the surgical global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,54145520,,Treatment of rectal prolapse,A,,0.54,4.44,,0.52,,0.07,5.05,1.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5424552F,,Pt ref for speech lang path,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5434553F,,Pt asst re end life issues,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,54445540,,Correct rectal prolapse,A,,17.67,8.32,NA,8.32,,3.18,29.17,29.17,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,54545541,,Correct rectal prolapse,A,,14.48,9.26,NA,9.26,,2.93,26.67,26.67,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5464554F,,Pt recvd inhal anesthetic,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,54745550,,Repair rectum/remove sigmoid,A,,24.18,11.73,NA,11.73,,4.58,40.49,40.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00