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Billing code 45910: Rectal dilationMedicare rate & RVUs

Dilation of a documented rectal stricture under anesthesia other than local, reported when the narrowed rectal segment is mechanically or balloon-expanded.

CMS RVU26DEffective Oct 1, 2026109 payment localities235 Medicare services in 2024

Medicare pays $188.05 for 45910 nationally in a facility.

Medicare rate · 45910

Rectal dilation

Work RVUs
2.78
Total RVUs
5.63
Global days
010

National rate · 2026

$188.05

Facility setting, before claim adjustments.

See every locality for 45910 →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 45910 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 45910 covers

This service treats a narrowed rectal segment by expanding the stricture, for example with a balloon or other dilation instrument. A colorectal or general surgeon typically performs the procedure in an operating or procedure room with anesthesia beyond local anesthesia. The clinical problem is a rectal narrowing requiring dilation, not simply a tight anal sphincter or a rectal obstruction that is removed.

Report the code when the operative note identifies the rectal stricture and documents its dilation and the anesthesia used. The 10-day global period includes related postoperative visits during that period. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, and 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 45910 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

45910 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$171.19
Alaska*Unavailable$232.42
ArizonaUnavailable$183.28
ArkansasUnavailable$169.11
AtlantaUnavailable$192.81
AustinUnavailable$191.00
BakersfieldUnavailable$191.14
Baltimore/Surr. CntysUnavailable$199.11
BeaumontUnavailable$179.78
BrazoriaUnavailable$184.55

45910 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
45910 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 45910 rate is calculated

Each of 45910’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 · 45910

RVUs × geographic indexes × conversion factor

Work2.78

2.78 RVUs× 1.000 GPCI

Practice expense2.37

2.37 RVUs× 1.000 GPCI

Malpractice0.48

0.48 RVUs× 1.000 GPCI

Adjusted RVUs

5.6300

Conversion factor

$33.4009

Medicare rate

$188.05

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

Payment rules and modifiers for 45910

45910 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 45910

Rectal dilation

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 45910

Rectal dilation

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

45910 without 51 · national facility

$188.05

Rectal dilation

45910-51 · Second procedure: 50%

$94.03

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

45910 compared with similar codes

Compare codes · National

4 codes, side by side

  • 45910

    Rectal dilation2.78 wRVU

    Not priced

  • 45905

    Anal dilation2.29 wRVU

    Not priced

  • 45340

    Sigmoidoscopy dilation1.22 wRVU

    $507.36

  • 45915

    Rectal obstruction removal3.11 wRVU

    $403.48

How to choose

45905Anal dilation
45905 addresses dilation of the anal sphincter; 45910 is for dilation of a rectal stricture. Choose based on the treated anatomy.
45340Sigmoidoscopy dilation
45340 describes stricture dilation performed with flexible sigmoidoscopy. Use 45910 for the rectal dilation service under anesthesia when the endoscopic service is not the appropriate description.
45915Rectal obstruction removal
45915 describes removal of a rectal obstruction. It is not the code for expanding a narrowed rectal segment.

Codes related to 45910

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

Codes related to 45910
CodeHow it relatesNational office range
Used instead
45905Anal dilationUse for dilation directed at anal sphincter narrowing rather than a rectal stricture.No office rate
45340Sigmoidoscopy dilationFlexible sigmoidoscopy with stricture dilation when the service is performed endoscopically.$439.61–$712.94
45999Unlisted procedure rectumUnlisted rectal procedure when no specific listed code describes the service.No office rate

45910 billing questions

How is rectal stricture dilation different from anal sphincter dilation?

Code 45910 is for a narrowing in the rectum. Code 45905 describes dilation directed at the anal sphincter, so the documented site determines the choice.

What documentation supports reporting 45910?

Document the rectal stricture, its location when known, the dilation performed, and anesthesia other than local. The note should distinguish the rectal narrowing from an anal sphincter problem.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure's payment.

Can modifier 50 be used?

No. The anatomy or descriptor makes a bilateral adjustment and modifier 50 inappropriate for this service.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction. An assistant at surgery is not paid; co-surgeons and team surgery are not permitted.

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 45910PPRRVU2026_Oct_nonQPP.csv, line 5,566 (RVU26D)

Open CMS sourceHow we calculate rates

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