No office rate
Choose 45905 for dilation of the anal sphincter; choose 45910 when the treated site is a rectal narrowing.
On this page
CMS RVU26D · Effective 2026-10-01
45905 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$172.11
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.
Anorectal procedure
About 45905: Anal sphincter dilation
Reports procedural dilation of the anal sphincter, commonly to relieve sphincter tightness associated with an anal fissure.
A colorectal or general surgeon dilates the anal sphincter to relieve tightness or spasm, often in a patient with an anal fissure. The procedure addresses the sphincter itself; it is distinct from dilation directed at a narrowing higher in the rectum. It may be performed in a procedural setting or operating room, depending on the patient and technique.
Report the service when the record supports actual sphincter dilation and identifies the indication and the structure treated. Document the relevant examination findings and the procedure performed; an evaluation or examination alone does not establish that dilation occurred. CMS 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. The anatomy is not suited to modifier 50. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 45905
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.29 · 45%
- Practice expense (office) RVU2.35 · 46%
- Malpractice RVU0.42 · 8%
336
Medicare services in 2024 · #3899 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.
45905 compared with similar codes
Office rates for Austin, from the same CMS release.
$326.53
45905 describes dilation of the anal sphincter. 46080 describes lateral sphincterotomy, a separate operative treatment for an anal fissure.
$551.53
45905 is sphincter dilation; 46200 is fissurectomy, with sphincterotomy when performed. The documented procedure, not the fissure diagnosis alone, determines the code.
The same code, a different location
How does Austin compare?
45905 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 · 45905
Office
Unavailable
Facility
$163.64
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 45905
Office
Unavailable
Facility
$181.80
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 45905
Office
Unavailable
Facility
$188.70
No comparable office rate is available.
Miami
Florida · 45905
Office
Unavailable
Facility
$193.68
No comparable office rate is available.
Chicago
Illinois · 45905
Office
Unavailable
Facility
$188.10
No comparable office rate is available.
Manhattan
New York · 45905
Office
Unavailable
Facility
$194.84
No comparable office rate is available.
Alaska*
Alaska · 45905
Office
Unavailable
Facility
$206.06
No comparable office rate is available.
Alabama
Alabama · 45905
Office
Unavailable
Facility
$153.11
No comparable office rate is available.
Arkansas
Arkansas · 45905
Office
Unavailable
Facility
$151.14
No comparable office rate is available.
Arizona
Arizona · 45905
Office
Unavailable
Facility
$164.56
No comparable office rate is available.
Bakersfield
California · 45905
Office
Unavailable
Facility
$172.51
No comparable office rate is available.
Chico
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
El Centro
California · 45905
Office
Unavailable
Facility
$171.41
No comparable office rate is available.
Fresno
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Hanford-Corcoran
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Madera
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Merced
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Modesto
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Napa
California · 45905
Office
Unavailable
Facility
$191.89
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 45905
Office
Unavailable
Facility
$180.15
No comparable office rate is available.
Redding
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Rest Of California
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 45905
Office
Unavailable
Facility
$175.86
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 45905
Office
Unavailable
Facility
$178.05
No comparable office rate is available.
Salinas
California · 45905
Office
Unavailable
Facility
$177.35
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 45905
Office
Unavailable
Facility
$180.26
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45905
Office
Unavailable
Facility
$200.87
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45905
Office
Unavailable
Facility
$200.39
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45905
Office
Unavailable
Facility
$205.61
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45905
Office
Unavailable
Facility
$203.66
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 45905
Office
Unavailable
Facility
$174.71
No comparable office rate is available.
Santa Cruz-Watsonville
California · 45905
Office
Unavailable
Facility
$180.98
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 45905
Office
Unavailable
Facility
$177.67
No comparable office rate is available.
Santa Rosa-Petaluma
California · 45905
Office
Unavailable
Facility
$182.69
No comparable office rate is available.
Stockton
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Vallejo
California · 45905
Office
Unavailable
Facility
$191.20
No comparable office rate is available.
Visalia
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Yuba City
California · 45905
Office
Unavailable
Facility
$171.33
No comparable office rate is available.
Colorado
Colorado · 45905
Office
Unavailable
Facility
$171.88
No comparable office rate is available.
Connecticut
Connecticut · 45905
Office
Unavailable
Facility
$179.53
No comparable office rate is available.
Delaware
Delaware · 45905
Office
Unavailable
Facility
$167.03
No comparable office rate is available.
Fort Lauderdale
Florida · 45905
Office
Unavailable
Facility
$181.36
No comparable office rate is available.
Rest Of Florida
Florida · 45905
Office
Unavailable
Facility
$172.61
No comparable office rate is available.
Atlanta
Georgia · 45905
Office
Unavailable
Facility
$173.31
No comparable office rate is available.
Rest Of Georgia
Georgia · 45905
Office
Unavailable
Facility
$163.22
No comparable office rate is available.
Hawaii, Guam
Hawaii · 45905
Office
Unavailable
Facility
$173.86
No comparable office rate is available.
Iowa
Iowa · 45905
Office
Unavailable
Facility
$153.88
No comparable office rate is available.
Idaho
Idaho · 45905
Office
Unavailable
Facility
$155.34
No comparable office rate is available.
East St. Louis
Illinois · 45905
Office
Unavailable
Facility
$176.95
No comparable office rate is available.
Rest Of Illinois
Illinois · 45905
Office
Unavailable
Facility
$170.08
No comparable office rate is available.
Suburban Chicago
Illinois · 45905
Office
Unavailable
Facility
$182.49
No comparable office rate is available.
Indiana
Indiana · 45905
Office
Unavailable
Facility
$156.07
No comparable office rate is available.
Kansas
Kansas · 45905
Office
Unavailable
Facility
$154.52
No comparable office rate is available.
Kentucky
Kentucky · 45905
Office
Unavailable
Facility
$159.10
No comparable office rate is available.
New Orleans
Louisiana · 45905
Office
Unavailable
Facility
$166.29
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 45905
Office
Unavailable
Facility
$159.39
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 45905
Office
Unavailable
Facility
$185.83
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 45905
Office
Unavailable
Facility
$171.54
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 45905
Office
Unavailable
Facility
$179.29
No comparable office rate is available.
Rest Of Maryland
Maryland · 45905
Office
Unavailable
Facility
$169.57
No comparable office rate is available.
Rest Of Maine
Maine · 45905
Office
Unavailable
Facility
$157.43
No comparable office rate is available.
Southern Maine
Maine · 45905
Office
Unavailable
Facility
$163.13
No comparable office rate is available.
Detroit
Michigan · 45905
Office
Unavailable
Facility
$175.88
No comparable office rate is available.
Rest Of Michigan
Michigan · 45905
Office
Unavailable
Facility
$163.99
No comparable office rate is available.
Minnesota
Minnesota · 45905
Office
Unavailable
Facility
$161.41
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 45905
Office
Unavailable
Facility
$163.90
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 45905
Office
Unavailable
Facility
$165.27
No comparable office rate is available.
Rest Of Missouri
Missouri · 45905
Office
Unavailable
Facility
$157.81
No comparable office rate is available.
Mississippi
Mississippi · 45905
Office
Unavailable
Facility
$154.44
No comparable office rate is available.
Montana**
Montana · 45905
Office
Unavailable
Facility
$168.98
No comparable office rate is available.
North Carolina
North Carolina · 45905
Office
Unavailable
Facility
$158.69
No comparable office rate is available.
North Dakota**
North Dakota · 45905
Office
Unavailable
Facility
$160.68
No comparable office rate is available.
Nebraska
Nebraska · 45905
Office
Unavailable
Facility
$154.24
No comparable office rate is available.
New Hampshire
New Hampshire · 45905
Office
Unavailable
Facility
$170.47
No comparable office rate is available.
Northern Nj
New Jersey · 45905
Office
Unavailable
Facility
$187.34
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 45905
Office
Unavailable
Facility
$180.65
No comparable office rate is available.
New Mexico
New Mexico · 45905
Office
Unavailable
Facility
$165.31
No comparable office rate is available.
Nevada**
Nevada · 45905
Office
Unavailable
Facility
$166.74
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 45905
Office
Unavailable
Facility
$200.76
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 45905
Office
Unavailable
Facility
$182.85
No comparable office rate is available.
Queens
New York · 45905
Office
Unavailable
Facility
$194.39
No comparable office rate is available.
Rest Of New York
New York · 45905
Office
Unavailable
Facility
$160.92
No comparable office rate is available.
Ohio
Ohio · 45905
Office
Unavailable
Facility
$162.29
No comparable office rate is available.
Oklahoma
Oklahoma · 45905
Office
Unavailable
Facility
$157.48
No comparable office rate is available.
Portland
Oregon · 45905
Office
Unavailable
Facility
$175.35
No comparable office rate is available.
Rest Of Oregon
Oregon · 45905
Office
Unavailable
Facility
$164.53
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 45905
Office
Unavailable
Facility
$176.31
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 45905
Office
Unavailable
Facility
$161.80
No comparable office rate is available.
Puerto Rico
Puerto Rico · 45905
Office
Unavailable
Facility
$169.66
No comparable office rate is available.
Rhode Island
Rhode Island · 45905
Office
Unavailable
Facility
$171.54
No comparable office rate is available.
South Carolina
South Carolina · 45905
Office
Unavailable
Facility
$160.94
No comparable office rate is available.
South Dakota**
South Dakota · 45905
Office
Unavailable
Facility
$159.69
No comparable office rate is available.
Tennessee
Tennessee · 45905
Office
Unavailable
Facility
$155.37
No comparable office rate is available.
Utah
Utah · 45905
Office
Unavailable
Facility
$162.87
No comparable office rate is available.
Virginia
Virginia · 45905
Office
Unavailable
Facility
$163.55
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 45905
Office
Unavailable
Facility
$169.66
No comparable office rate is available.
Vermont
Vermont · 45905
Office
Unavailable
Facility
$161.29
No comparable office rate is available.
Rest Of Washington
Washington · 45905
Office
Unavailable
Facility
$170.81
No comparable office rate is available.
Seattle (King Cnty)
Washington · 45905
Office
Unavailable
Facility
$188.08
No comparable office rate is available.
Wisconsin
Wisconsin · 45905
Office
Unavailable
Facility
$156.00
No comparable office rate is available.
West Virginia
West Virginia · 45905
Office
Unavailable
Facility
$164.77
No comparable office rate is available.
Wyoming**
Wyoming · 45905
Office
Unavailable
Facility
$165.36
No comparable office rate is available.
See how rates vary across the country
45905 · 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.
- 45905 in Austin
Multiple payment areas
- 45905 in Barton Creek
- 45905 in Bee Cave
- 45905 in Briarcliff
- 45905 in Cedar Park
Multiple payment areas
- 45905 in Creedmoor
Multiple payment areas
- 45905 in Elgin
Multiple payment areas
- 45905 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 45905 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$189.32
$172.11 × 110% = $189.32
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 45905 in Austin.
PPRRVU2026_Oct_nonQPP.csv
5,565
- Code
- 45905
- Physician work
- 2.29
- Practice expense
- 2.35
- Malpractice
- 0.42
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.29 | × 1.002 | 2.2946 |
| Practice expense | 2.35 | × 1.058 | 2.4863 |
| Malpractice | 0.42 | × 0.886 | 0.3721 |
| Total RVUs | 5.1530 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$172.11
Open 45905 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.29 | 1.002 |
| Practice expense | 2.35 | 1.058 |
| Malpractice | 0.42 | 0.886 |
(2.29 × 1.002 + 2.35 × 1.058 + 0.42 × 0.886) × $33.4009 = $172.11
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
45905 · 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 | $172.11 | RVU26D |
| 2026-07-01 | Not available in this setting | $172.11 | RVU26C |
| 2026-04-01 | Not available in this setting | $172.11 | RVU26B |
| 2026-01-01 | Not available in this setting | $172.11 | RVU26A |
| 2025-10-01 | Not available in this setting | $169.93 | RVU25D |
| 2025-07-01 | Not available in this setting | $169.93 | RVU25C |
| 2025-04-01 | Not available in this setting | $169.93 | RVU25B |
| 2025-01-01 | Not available in this setting | $169.93 | RVU25A |
45905 billing questions
When is 45905 appropriate for a patient with an anal fissure?
Use it when the documented procedure dilates the anal sphincter, such as to address fissure-associated tightness or spasm. A fissure diagnosis by itself does not show that sphincter dilation was performed.
How is 45905 different from 45910?
45905 treats the anal sphincter. 45910 is for dilation directed at a rectal narrowing, so select based on the structure actually dilated.
Does 45905 have a postoperative global period?
Yes. CMS assigns a 10-day global period, which includes related postoperative visits during that period.
Can modifier 50 be used for 45905?
No. The anatomy and service do not support bilateral reporting with modifier 50.
How does Medicare handle 45905 when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Medicare does not pay an assistant at surgery; co-surgeons and team surgeons 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 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.
5,56245820,,Repair rectourethral fistula,A,,19.86,11.13,NA,11.13,,5.30,36.29,36.29,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56345825,,Repair fistula w/colostomy,A,,23.57,13.90,NA,13.90,,6.31,43.78,43.78,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56445900,,Reduction of rectal prolapse,A,,2.92,2.62,NA,2.62,,0.79,6.33,6.33,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56545905,,Dilation of anal sphincter,A,,2.29,2.35,NA,2.35,,0.42,5.06,5.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56645910,,Dilation of rectal narrowing,A,,2.78,2.37,NA,2.37,,0.48,5.63,5.63,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56745915,,Remove rectal obstruction,A,,3.11,8.35,,3.21,,0.62,12.08,6.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56845990,,Surg dx exam anorectal,A,,1.76,0.87,NA,0.87,,0.35,2.98,2.98,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,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