No office rate
Both codes address excision of rectal prolapse, but 45135 uses an abdominal approach and 45130 uses a perineal approach.
On this page
CMS RVU26D · Effective 2026-10-01
45135 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1206.70
Base rate per service
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.
Colorectal surgery
About 45135: Abdominal excision of rectal prolapse
Reports abdominal surgery to excise rectal prolapse, distinguished from perineal excision and from procedures that suspend the rectum without excising it.
This code describes an abdominal operation to remove tissue involved in rectal prolapse. A colorectal or general surgeon typically performs the procedure in a hospital operating room for a patient whose prolapse is being treated through an abdominal approach. The operative report should make the approach and excision clear, and describe the prolapse and any reconstruction performed. It is distinct from perineal excision, which uses a different operative route.
Choose this code when the documented operation excises the prolapsed rectum through an abdominal approach; do not select it solely because the surgeon treats prolapse. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45135
- 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 RVU21.80 · 61%
- Practice expense (office) RVU10.88 · 30%
- Malpractice RVU3.13 · 9%
21
Medicare services in 2024 · #5896 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.
45135 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
45540 describes abdominal rectopexy to treat prolapse. Use 45135 when the documented operation includes abdominal excision of prolapsed rectal tissue.
No office rate
45550 combines abdominal rectopexy with sigmoid resection. Distinguish it from 45135 by the documented procedure and whether rectopexy with sigmoid resection was performed.
The same code, a different location
How does Austin compare?
45135 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 45135
Office
Unavailable
Facility
$1167.41
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 45135
Office
Unavailable
Facility
$1257.32
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 45135
Office
Unavailable
Facility
$1311.90
No comparable office rate is available.
Miami
Florida · 45135
Office
Unavailable
Facility
$1370.83
No comparable office rate is available.
Chicago
Illinois · 45135
Office
Unavailable
Facility
$1338.39
No comparable office rate is available.
Manhattan
New York · 45135
Office
Unavailable
Facility
$1362.82
No comparable office rate is available.
Alaska*
Alaska · 45135
Office
Unavailable
Facility
$1536.84
No comparable office rate is available.
Alabama
Alabama · 45135
Office
Unavailable
Facility
$1105.29
No comparable office rate is available.
Arkansas
Arkansas · 45135
Office
Unavailable
Facility
$1094.14
No comparable office rate is available.
Arizona
Arizona · 45135
Office
Unavailable
Facility
$1169.77
No comparable office rate is available.
Bakersfield
California · 45135
Office
Unavailable
Facility
$1203.93
No comparable office rate is available.
Chico
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
El Centro
California · 45135
Office
Unavailable
Facility
$1195.37
No comparable office rate is available.
Fresno
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Hanford-Corcoran
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Madera
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Merced
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Modesto
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Napa
California · 45135
Office
Unavailable
Facility
$1306.08
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 45135
Office
Unavailable
Facility
$1243.20
No comparable office rate is available.
Redding
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Rest Of California
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 45135
Office
Unavailable
Facility
$1228.71
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 45135
Office
Unavailable
Facility
$1233.02
No comparable office rate is available.
Salinas
California · 45135
Office
Unavailable
Facility
$1227.93
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 45135
Office
Unavailable
Facility
$1241.28
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45135
Office
Unavailable
Facility
$1357.70
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45135
Office
Unavailable
Facility
$1354.14
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45135
Office
Unavailable
Facility
$1388.30
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45135
Office
Unavailable
Facility
$1373.76
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 45135
Office
Unavailable
Facility
$1210.47
No comparable office rate is available.
Santa Cruz-Watsonville
California · 45135
Office
Unavailable
Facility
$1241.00
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 45135
Office
Unavailable
Facility
$1228.29
No comparable office rate is available.
Santa Rosa-Petaluma
California · 45135
Office
Unavailable
Facility
$1252.28
No comparable office rate is available.
Stockton
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Vallejo
California · 45135
Office
Unavailable
Facility
$1300.96
No comparable office rate is available.
Visalia
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Yuba City
California · 45135
Office
Unavailable
Facility
$1194.84
No comparable office rate is available.
Colorado
Colorado · 45135
Office
Unavailable
Facility
$1205.19
No comparable office rate is available.
Connecticut
Connecticut · 45135
Office
Unavailable
Facility
$1260.59
No comparable office rate is available.
Delaware
Delaware · 45135
Office
Unavailable
Facility
$1184.81
No comparable office rate is available.
Fort Lauderdale
Florida · 45135
Office
Unavailable
Facility
$1285.28
No comparable office rate is available.
Rest Of Florida
Florida · 45135
Office
Unavailable
Facility
$1232.68
No comparable office rate is available.
Atlanta
Georgia · 45135
Office
Unavailable
Facility
$1225.10
No comparable office rate is available.
Rest Of Georgia
Georgia · 45135
Office
Unavailable
Facility
$1176.91
No comparable office rate is available.
Hawaii, Guam
Hawaii · 45135
Office
Unavailable
Facility
$1201.86
No comparable office rate is available.
Iowa
Iowa · 45135
Office
Unavailable
Facility
$1102.16
No comparable office rate is available.
Idaho
Idaho · 45135
Office
Unavailable
Facility
$1111.92
No comparable office rate is available.
East St. Louis
Illinois · 45135
Office
Unavailable
Facility
$1273.02
No comparable office rate is available.
Rest Of Illinois
Illinois · 45135
Office
Unavailable
Facility
$1223.33
No comparable office rate is available.
Suburban Chicago
Illinois · 45135
Office
Unavailable
Facility
$1291.70
No comparable office rate is available.
Indiana
Indiana · 45135
Office
Unavailable
Facility
$1115.82
No comparable office rate is available.
Kansas
Kansas · 45135
Office
Unavailable
Facility
$1109.35
No comparable office rate is available.
Kentucky
Kentucky · 45135
Office
Unavailable
Facility
$1146.86
No comparable office rate is available.
New Orleans
Louisiana · 45135
Office
Unavailable
Facility
$1188.86
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 45135
Office
Unavailable
Facility
$1149.90
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 45135
Office
Unavailable
Facility
$1284.94
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 45135
Office
Unavailable
Facility
$1205.77
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 45135
Office
Unavailable
Facility
$1259.04
No comparable office rate is available.
Rest Of Maryland
Maryland · 45135
Office
Unavailable
Facility
$1199.16
No comparable office rate is available.
Rest Of Maine
Maine · 45135
Office
Unavailable
Facility
$1127.50
No comparable office rate is available.
Southern Maine
Maine · 45135
Office
Unavailable
Facility
$1154.24
No comparable office rate is available.
Detroit
Michigan · 45135
Office
Unavailable
Facility
$1255.08
No comparable office rate is available.
Rest Of Michigan
Michigan · 45135
Office
Unavailable
Facility
$1177.96
No comparable office rate is available.
Minnesota
Minnesota · 45135
Office
Unavailable
Facility
$1133.03
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 45135
Office
Unavailable
Facility
$1171.51
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 45135
Office
Unavailable
Facility
$1178.85
No comparable office rate is available.
Rest Of Missouri
Missouri · 45135
Office
Unavailable
Facility
$1143.22
No comparable office rate is available.
Mississippi
Mississippi · 45135
Office
Unavailable
Facility
$1118.29
No comparable office rate is available.
Montana**
Montana · 45135
Office
Unavailable
Facility
$1195.88
No comparable office rate is available.
North Carolina
North Carolina · 45135
Office
Unavailable
Facility
$1134.00
No comparable office rate is available.
North Dakota**
North Dakota · 45135
Office
Unavailable
Facility
$1133.99
No comparable office rate is available.
Nebraska
Nebraska · 45135
Office
Unavailable
Facility
$1103.08
No comparable office rate is available.
New Hampshire
New Hampshire · 45135
Office
Unavailable
Facility
$1197.92
No comparable office rate is available.
Northern Nj
New Jersey · 45135
Office
Unavailable
Facility
$1307.21
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 45135
Office
Unavailable
Facility
$1268.79
No comparable office rate is available.
New Mexico
New Mexico · 45135
Office
Unavailable
Facility
$1186.94
No comparable office rate is available.
Nevada**
Nevada · 45135
Office
Unavailable
Facility
$1178.99
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 45135
Office
Unavailable
Facility
$1400.97
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 45135
Office
Unavailable
Facility
$1285.33
No comparable office rate is available.
Queens
New York · 45135
Office
Unavailable
Facility
$1355.04
No comparable office rate is available.
Rest Of New York
New York · 45135
Office
Unavailable
Facility
$1146.87
No comparable office rate is available.
Ohio
Ohio · 45135
Office
Unavailable
Facility
$1165.31
No comparable office rate is available.
Oklahoma
Oklahoma · 45135
Office
Unavailable
Facility
$1133.89
No comparable office rate is available.
Portland
Oregon · 45135
Office
Unavailable
Facility
$1221.31
No comparable office rate is available.
Rest Of Oregon
Oregon · 45135
Office
Unavailable
Facility
$1163.58
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 45135
Office
Unavailable
Facility
$1244.27
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 45135
Office
Unavailable
Facility
$1160.54
No comparable office rate is available.
Puerto Rico
Puerto Rico · 45135
Office
Unavailable
Facility
$1198.52
No comparable office rate is available.
Rhode Island
Rhode Island · 45135
Office
Unavailable
Facility
$1210.62
No comparable office rate is available.
South Carolina
South Carolina · 45135
Office
Unavailable
Facility
$1152.79
No comparable office rate is available.
South Dakota**
South Dakota · 45135
Office
Unavailable
Facility
$1126.67
No comparable office rate is available.
Tennessee
Tennessee · 45135
Office
Unavailable
Facility
$1114.61
No comparable office rate is available.
Utah
Utah · 45135
Office
Unavailable
Facility
$1163.62
No comparable office rate is available.
Virginia
Virginia · 45135
Office
Unavailable
Facility
$1159.17
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 45135
Office
Unavailable
Facility
$1198.52
No comparable office rate is available.
Vermont
Vermont · 45135
Office
Unavailable
Facility
$1140.81
No comparable office rate is available.
Rest Of Washington
Washington · 45135
Office
Unavailable
Facility
$1199.83
No comparable office rate is available.
Seattle (King Cnty)
Washington · 45135
Office
Unavailable
Facility
$1295.85
No comparable office rate is available.
Wisconsin
Wisconsin · 45135
Office
Unavailable
Facility
$1108.48
No comparable office rate is available.
West Virginia
West Virginia · 45135
Office
Unavailable
Facility
$1193.54
No comparable office rate is available.
Wyoming**
Wyoming · 45135
Office
Unavailable
Facility
$1168.90
No comparable office rate is available.
See how rates vary across the country
45135 · 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 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 45135 in Austin
Multiple payment areas
- 45135 in Barton Creek
- 45135 in Bee Cave
- 45135 in Briarcliff
- 45135 in Cedar Park
Multiple payment areas
- 45135 in Creedmoor
Multiple payment areas
- 45135 in Elgin
Multiple payment areas
- 45135 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 45135 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1327.37
$1206.70 × 110% = $1327.37
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 45135 in Austin.
PPRRVU2026_Oct_nonQPP.csv
5,478
- Code
- 45135
- Physician work
- 21.80
- Practice expense
- 10.88
- Malpractice
- 3.13
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.80 | × 1.002 | 21.8436 |
| Practice expense | 10.88 | × 1.058 | 11.5110 |
| Malpractice | 3.13 | × 0.886 | 2.7732 |
| Total RVUs | 36.1278 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$1206.70
Open 45135 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.8 | 1.002 |
| Practice expense | 10.88 | 1.058 |
| Malpractice | 3.13 | 0.886 |
(21.8 × 1.002 + 10.88 × 1.058 + 3.13 × 0.886) × $33.4009 = $1206.70
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
45135 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1206.70 | RVU26D |
| 2026-07-01 | Not available in this setting | $1206.70 | RVU26C |
| 2026-04-01 | Not available in this setting | $1206.70 | RVU26B |
| 2026-01-01 | Not available in this setting | $1206.70 | RVU26A |
| 2025-10-01 | Not available in this setting | $1267.37 | RVU25D |
| 2025-07-01 | Not available in this setting | $1267.37 | RVU25C |
| 2025-04-01 | Not available in this setting | $1267.37 | RVU25B |
| 2025-01-01 | Not available in this setting | $1267.37 | RVU25A |
45135 billing questions
How does this differ from 45130?
45135 is for excision of rectal prolapse through an abdominal approach. 45130 describes the perineal approach; follow the operative report rather than the diagnosis alone.
Is rectopexy alone reported with this code?
No. This code describes excision of prolapsed rectal tissue through an abdominal approach. A rectopexy without excision is a different procedure, such as 45540.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
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-surgeons require supporting documentation.
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.
5,47545123,,Partial proctectomy,A,,18.39,9.25,NA,9.25,,3.28,30.92,30.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47645126,,Pelvic exenteration,A,,47.87,18.16,NA,18.16,,8.30,74.33,74.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47745130,,Excision of rectal prolapse,A,,18.04,8.80,NA,8.80,,3.24,30.08,30.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47845135,,Excision of rectal prolapse,A,,21.80,10.88,NA,10.88,,3.13,35.81,35.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47945136,,Excise ileoanal reservior,A,,30.05,14.58,NA,14.58,,4.32,48.95,48.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48045150,,Excision of rectal stricture,A,,5.70,5.31,NA,5.31,,1.51,12.52,12.52,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48145160,,Excision of rectal lesion,A,,15.92,9.06,NA,9.06,,4.25,29.23,29.23,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858