Billing code 45915: Rectal obstruction removalMedicare rate & RVUs

Medicare pays $403.48 for 45915 nationally in the office and $231.80 in a hospital or facility. Local office rates run $354.11–$528.57.

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

What 45915 covers

This service covers removal of obstructing material from the rectum when the work is performed under anesthesia. Typical cases include a substantial fecal impaction or a rectal foreign body that requires procedural extraction rather than routine office or bedside care. Colorectal and general surgeons commonly perform it in a hospital or ambulatory surgical setting; the clinical record should identify the obstruction and describe the removal performed.

Select the code for the extraction itself, not for treatment of a narrowing, sphincter problem, or prolapse that may cause obstructive symptoms. Document the material removed, the anatomic site, the technique, and the use of anesthesia. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code; assistant-at-surgery payment is restricted, 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 45915 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

45915 rates by state

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

How the 45915 rate is calculated

Each of 45915’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 45915

45915 has a 10-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

45915 compared with similar codes

How to choose

45910Rectal dilation

Choose 45915 for extraction of obstructing material. Choose 45910 when the intervention dilates a rectal narrowing.

45905Anal dilation

45905 is for dilation of the anal sphincter; 45915 removes obstructing material from the rectum under anesthesia.

45900Prolapse reduction

45900 addresses reduction of rectal prolapse. It is not the extraction code for fecal impaction or a rectal foreign body.

Codes related to 45915

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