No office rate
Both describe laparoscopic proctopexy for prolapse. Choose 45402 when sigmoid resection is part of the operation; 45400 is for proctopexy without that resection.
On this page
CMS RVU26D · Effective 2026-10-01
45400 in Chico
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1031.86
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 45400: Laparoscopic proctopexy for rectal prolapse
Laparoscopic proctopexy fixes the rectum for rectal prolapse; report this code when the procedure is performed without sigmoid resection.
This operation uses a laparoscopic approach to secure the rectum in the pelvis for treatment of rectal prolapse. It is typically performed by a colorectal or general surgeon in a hospital or other surgical facility. This code describes proctopexy without sigmoid resection; when sigmoid resection is part of the prolapse operation, a different code applies.
Report the procedure performed, supported by documentation of the prolapse, laparoscopic approach, rectopexy, and whether sigmoid resection was done. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 45400
- 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 RVU18.95 · 61%
- Practice expense (office) RVU8.96 · 29%
- Malpractice RVU3.36 · 11%
2.3K
Medicare services in 2024 · #2368 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.
45400 compared with similar codes
Office rates for Chico, from the same CMS release.
No office rate
This code describes abdominal proctopexy by an open approach. Use 45400 when the rectopexy is performed laparoscopically.
No office rate
This code describes open abdominal proctopexy with sigmoid resection. For a laparoscopic repair with resection, compare 45402.
The same code, a different location
How does Chico compare?
45400 across payment areas
Same release and payment basis · bars start at $0
Chico · 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.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California 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
Merced
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Modesto
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Napa
California · 45400
Office
Unavailable
Facility
$1124.27
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 45400
Office
Unavailable
Facility
$1074.33
No comparable office rate is available.
Redding
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Rest Of California
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 45400
Office
Unavailable
Facility
$1068.07
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 45400
Office
Unavailable
Facility
$1063.94
No comparable office rate is available.
Salinas
California · 45400
Office
Unavailable
Facility
$1059.58
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 45400
Office
Unavailable
Facility
$1070.69
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45400
Office
Unavailable
Facility
$1166.56
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45400
Office
Unavailable
Facility
$1162.75
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45400
Office
Unavailable
Facility
$1194.28
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45400
Office
Unavailable
Facility
$1178.68
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 45400
Office
Unavailable
Facility
$1044.73
No comparable office rate is available.
Santa Cruz-Watsonville
California · 45400
Office
Unavailable
Facility
$1070.01
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 45400
Office
Unavailable
Facility
$1059.77
No comparable office rate is available.
Santa Rosa-Petaluma
California · 45400
Office
Unavailable
Facility
$1079.60
No comparable office rate is available.
Stockton
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Vallejo
California · 45400
Office
Unavailable
Facility
$1118.78
No comparable office rate is available.
Visalia
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Yuba City
California · 45400
Office
Unavailable
Facility
$1031.86
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 45400
Office
Unavailable
Facility
$1144.58
No comparable office rate is available.
Miami
Florida · 45400
Office
Unavailable
Facility
$1228.31
No comparable office rate is available.
Chicago
Illinois · 45400
Office
Unavailable
Facility
$1195.71
No comparable office rate is available.
Manhattan
New York · 45400
Office
Unavailable
Facility
$1199.20
No comparable office rate is available.
Alaska*
Alaska · 45400
Office
Unavailable
Facility
$1329.98
No comparable office rate is available.
Alabama
Alabama · 45400
Office
Unavailable
Facility
$958.33
No comparable office rate is available.
Arkansas
Arkansas · 45400
Office
Unavailable
Facility
$947.82
No comparable office rate is available.
Arizona
Arizona · 45400
Office
Unavailable
Facility
$1019.01
No comparable office rate is available.
Colorado
Colorado · 45400
Office
Unavailable
Facility
$1046.62
No comparable office rate is available.
Connecticut
Connecticut · 45400
Office
Unavailable
Facility
$1103.72
No comparable office rate is available.
Delaware
Delaware · 45400
Office
Unavailable
Facility
$1032.68
No comparable office rate is available.
Fort Lauderdale
Florida · 45400
Office
Unavailable
Facility
$1139.02
No comparable office rate is available.
Rest Of Florida
Florida · 45400
Office
Unavailable
Facility
$1087.73
No comparable office rate is available.
Atlanta
Georgia · 45400
Office
Unavailable
Facility
$1073.69
No comparable office rate is available.
Rest Of Georgia
Georgia · 45400
Office
Unavailable
Facility
$1033.67
No comparable office rate is available.
Hawaii, Guam
Hawaii · 45400
Office
Unavailable
Facility
$1038.20
No comparable office rate is available.
Iowa
Iowa · 45400
Office
Unavailable
Facility
$951.34
No comparable office rate is available.
Idaho
Idaho · 45400
Office
Unavailable
Facility
$961.36
No comparable office rate is available.
East St. Louis
Illinois · 45400
Office
Unavailable
Facility
$1134.30
No comparable office rate is available.
Rest Of Illinois
Illinois · 45400
Office
Unavailable
Facility
$1081.59
No comparable office rate is available.
Suburban Chicago
Illinois · 45400
Office
Unavailable
Facility
$1143.60
No comparable office rate is available.
Indiana
Indiana · 45400
Office
Unavailable
Facility
$964.91
No comparable office rate is available.
Kansas
Kansas · 45400
Office
Unavailable
Facility
$960.05
No comparable office rate is available.
Kentucky
Kentucky · 45400
Office
Unavailable
Facility
$1001.69
No comparable office rate is available.
New Orleans
Louisiana · 45400
Office
Unavailable
Facility
$1042.05
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 45400
Office
Unavailable
Facility
$1005.32
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 45400
Office
Unavailable
Facility
$1116.11
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 45400
Office
Unavailable
Facility
$1047.65
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 45400
Office
Unavailable
Facility
$1103.02
No comparable office rate is available.
Rest Of Maryland
Maryland · 45400
Office
Unavailable
Facility
$1045.16
No comparable office rate is available.
Rest Of Maine
Maine · 45400
Office
Unavailable
Facility
$978.08
No comparable office rate is available.
Southern Maine
Maine · 45400
Office
Unavailable
Facility
$1000.34
No comparable office rate is available.
Detroit
Michigan · 45400
Office
Unavailable
Facility
$1110.96
No comparable office rate is available.
Rest Of Michigan
Michigan · 45400
Office
Unavailable
Facility
$1032.89
No comparable office rate is available.
Minnesota
Minnesota · 45400
Office
Unavailable
Facility
$974.12
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 45400
Office
Unavailable
Facility
$1023.61
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 45400
Office
Unavailable
Facility
$1030.31
No comparable office rate is available.
Rest Of Missouri
Missouri · 45400
Office
Unavailable
Facility
$1000.23
No comparable office rate is available.
Mississippi
Mississippi · 45400
Office
Unavailable
Facility
$973.56
No comparable office rate is available.
Montana**
Montana · 45400
Office
Unavailable
Facility
$1044.22
No comparable office rate is available.
North Carolina
North Carolina · 45400
Office
Unavailable
Facility
$983.88
No comparable office rate is available.
North Dakota**
North Dakota · 45400
Office
Unavailable
Facility
$977.78
No comparable office rate is available.
Nebraska
Nebraska · 45400
Office
Unavailable
Facility
$951.60
No comparable office rate is available.
New Hampshire
New Hampshire · 45400
Office
Unavailable
Facility
$1042.69
No comparable office rate is available.
Northern Nj
New Jersey · 45400
Office
Unavailable
Facility
$1139.84
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 45400
Office
Unavailable
Facility
$1108.18
No comparable office rate is available.
New Mexico
New Mexico · 45400
Office
Unavailable
Facility
$1042.16
No comparable office rate is available.
Nevada**
Nevada · 45400
Office
Unavailable
Facility
$1026.00
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 45400
Office
Unavailable
Facility
$1237.70
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 45400
Office
Unavailable
Facility
$1124.93
No comparable office rate is available.
Queens
New York · 45400
Office
Unavailable
Facility
$1189.03
No comparable office rate is available.
Rest Of New York
New York · 45400
Office
Unavailable
Facility
$996.15
No comparable office rate is available.
Ohio
Ohio · 45400
Office
Unavailable
Facility
$1019.31
No comparable office rate is available.
Oklahoma
Oklahoma · 45400
Office
Unavailable
Facility
$987.40
No comparable office rate is available.
Portland
Oregon · 45400
Office
Unavailable
Facility
$1059.06
No comparable office rate is available.
Rest Of Oregon
Oregon · 45400
Office
Unavailable
Facility
$1009.92
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 45400
Office
Unavailable
Facility
$1089.77
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 45400
Office
Unavailable
Facility
$1013.73
No comparable office rate is available.
Puerto Rico
Puerto Rico · 45400
Office
Unavailable
Facility
$1046.05
No comparable office rate is available.
Rhode Island
Rhode Island · 45400
Office
Unavailable
Facility
$1054.23
No comparable office rate is available.
South Carolina
South Carolina · 45400
Office
Unavailable
Facility
$1004.87
No comparable office rate is available.
South Dakota**
South Dakota · 45400
Office
Unavailable
Facility
$969.93
No comparable office rate is available.
Tennessee
Tennessee · 45400
Office
Unavailable
Facility
$965.25
No comparable office rate is available.
Austin
Texas · 45400
Office
Unavailable
Facility
$1050.28
No comparable office rate is available.
Beaumont
Texas · 45400
Office
Unavailable
Facility
$1009.54
No comparable office rate is available.
Brazoria
Texas · 45400
Office
Unavailable
Facility
$1022.13
No comparable office rate is available.
Dallas
Texas · 45400
Office
Unavailable
Facility
$1033.01
No comparable office rate is available.
Fort Worth
Texas · 45400
Office
Unavailable
Facility
$1031.48
No comparable office rate is available.
Galveston
Texas · 45400
Office
Unavailable
Facility
$1028.11
No comparable office rate is available.
Houston
Texas · 45400
Office
Unavailable
Facility
$1089.61
No comparable office rate is available.
Rest Of Texas
Texas · 45400
Office
Unavailable
Facility
$1018.30
No comparable office rate is available.
Utah
Utah · 45400
Office
Unavailable
Facility
$1015.04
No comparable office rate is available.
Virginia
Virginia · 45400
Office
Unavailable
Facility
$1006.36
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 45400
Office
Unavailable
Facility
$1046.05
No comparable office rate is available.
Vermont
Vermont · 45400
Office
Unavailable
Facility
$986.01
No comparable office rate is available.
Rest Of Washington
Washington · 45400
Office
Unavailable
Facility
$1041.71
No comparable office rate is available.
Seattle (King Cnty)
Washington · 45400
Office
Unavailable
Facility
$1123.49
No comparable office rate is available.
Wisconsin
Wisconsin · 45400
Office
Unavailable
Facility
$954.22
No comparable office rate is available.
West Virginia
West Virginia · 45400
Office
Unavailable
Facility
$1053.61
No comparable office rate is available.
Wyoming**
Wyoming · 45400
Office
Unavailable
Facility
$1015.27
No comparable office rate is available.
See how rates vary across the country
45400 · 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?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 45400 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1135.05
$1031.86 × 110% = $1135.05
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 45400 in Chico.
PPRRVU2026_Oct_nonQPP.csv
5,532
- Code
- 45400
- Physician work
- 18.95
- Practice expense
- 8.96
- Malpractice
- 3.36
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.95 | × 1.017 | 19.2721 |
| Practice expense | 8.96 | × 1.096 | 9.8202 |
| Malpractice | 3.36 | × 0.536 | 1.8010 |
| Total RVUs | 30.8933 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Chico$1031.86
Open 45400 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.95 | 1.017 |
| Practice expense | 8.96 | 1.096 |
| Malpractice | 3.36 | 0.536 |
(18.95 × 1.017 + 8.96 × 1.096 + 3.36 × 0.536) × $33.4009 = $1031.86
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
45400 · 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 | $1031.86 | RVU26D |
| 2026-07-01 | Not available in this setting | $1031.86 | RVU26C |
| 2026-04-01 | Not available in this setting | $1031.86 | RVU26B |
| 2026-01-01 | Not available in this setting | $1031.86 | RVU26A |
| 2025-10-01 | Not available in this setting | $1092.81 | RVU25D |
| 2025-07-01 | Not available in this setting | $1092.81 | RVU25C |
| 2025-04-01 | Not available in this setting | $1092.81 | RVU25B |
| 2025-01-01 | Not available in this setting | $1092.81 | RVU25A |
45400 billing questions
When should 45400 be reported instead of 45402?
Use 45400 for laparoscopic proctopexy without sigmoid resection. When sigmoid resection is performed as part of the prolapse operation, use 45402.
Can modifier 50 be used for this procedure?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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.
5,52945397,,Lap remove rectum w/pouch,A,,35.59,16.39,NA,16.39,,6.16,58.14,58.14,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53045398,,Colonoscopy w/band ligation,A,,4.10,22.32,,1.57,,0.60,27.02,6.27,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,53145399,,Unlisted procedure colon,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53245400,,Laparoscopic proc,A,,18.95,8.96,NA,8.96,,3.36,31.27,31.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53345402,,Lap proctopexy w/sig resect,A,,25.85,10.84,NA,10.84,,5.01,41.70,41.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5344540F,,Disease modif pharmacothxpy,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
5,5354541F,,Pt offered tx for pseudobulb,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
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536