FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

45520 in El Centro

Office / nonfacility

$182.14

Base rate per service

Facility setting

$38.64

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 45520: Local treatment of rectal prolapse

Reports a local treatment for rectal prolapse, such as injection therapy, rather than a formal abdominal or perineal prolapse repair.

This service covers a treatment directed at rectal prolapse without the formal abdominal or perineal repair described by the related repair codes. A colorectal or general surgeon may perform a local treatment, such as injection therapy, in an outpatient setting. The record should identify the prolapse and the treatment method performed so the service can be distinguished from repair of the rectum or surgery to correct prolapse through an abdominal or perineal approach.

Report the service based on the treatment actually performed, not simply the diagnosis of prolapse. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is 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. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

CMS billing rules for 45520

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU0.54 · 11%
  • Practice expense (office) RVU4.44 · 88%
  • Malpractice RVU0.07 · 1%

186

Medicare services in 2024 · #4382 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.

45520 compared with similar codes

Office rates for El Centro, from the same CMS release.

45540

Rectal prolapse repair

Abdominal approach

No office rate

Choose 45540 for repair of rectal prolapse through an abdominal approach; this code describes local treatment rather than that formal repair.

45541

Prolapse repair

Perineal approach

No office rate

Choose 45541 when the prolapse is repaired through a perineal approach. This code is for local treatment, not that approach-specific repair.

45550

Rectal repair

With sigmoid resection

No office rate

45550 describes abdominal prolapse repair that includes sigmoid resection. This code does not represent that combined repair.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 45520 is $182.34—$0.20 higher than the $182.14 rate in El Centro. Both use the same code, release and participation basis.

45520 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $182.14

  2. Bakersfield

    $182.34

    $0.20 higher than El Centro

  3. Chico

    $182.13

    $0.01 lower than El Centro

  4. Fresno

    $182.13

    $0.01 lower than El Centro

  5. Hanford-Corcoran

    $182.13

    $0.01 lower than El Centro

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $195.77

    $13.63 higher than El Centro

  7. Madera

    $182.13

    $0.01 lower than El Centro

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 45520 ranges from $146.63 in Arkansas to $235.12 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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 · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Modesto

    California · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Napa

    California · 45520

    Office

    $215.82

    Facility

    $43.25

    $33.68 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45520

    Office

    $195.29

    Facility

    $40.53

    $13.15 higher than El Centro for the office setting.

  • Redding

    California · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Rest Of California

    California · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45520

    Office

    $182.89

    Facility

    $39.39

    $0.75 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45520

    Office

    $192.41

    Facility

    $40.14

    $10.27 higher than El Centro for the office setting.

  • Salinas

    California · 45520

    Office

    $191.73

    Facility

    $39.98

    $9.59 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45520

    Office

    $197.21

    Facility

    $40.62

    $15.07 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45520

    Office

    $229.93

    Facility

    $45.31

    $47.79 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 45520

    Office

    $229.85

    Facility

    $45.23

    $47.71 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 45520

    Office

    $235.12

    Facility

    $46.32

    $52.98 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 45520

    Office

    $234.80

    Facility

    $45.99

    $52.66 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45520

    Office

    $188.51

    Facility

    $39.38

    $6.37 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 45520

    Office

    $199.85

    Facility

    $40.77

    $17.71 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 45520

    Office

    $192.71

    Facility

    $40.05

    $10.57 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 45520

    Office

    $201.94

    Facility

    $41.16

    $19.80 higher than El Centro for the office setting.

  • Stockton

    California · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Vallejo

    California · 45520

    Office

    $215.71

    Facility

    $43.14

    $33.57 higher than El Centro for the office setting.

  • Visalia

    California · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Yuba City

    California · 45520

    Office

    $182.13

    Facility

    $38.63

    $0.01 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45520

    Office

    $196.31

    Facility

    $42.07

    $14.17 higher than El Centro for the office setting.

  • Miami

    Florida · 45520

    Office

    $178.33

    Facility

    $42.03

    $3.81 lower than El Centro for the office setting.

  • Chicago

    Illinois · 45520

    Office

    $172.57

    Facility

    $40.98

    $9.57 lower than El Centro for the office setting.

  • Manhattan

    New York · 45520

    Office

    $195.22

    Facility

    $43.08

    $13.08 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 45520

    Office

    $186.28

    Facility

    $46.84

    $4.14 higher than El Centro for the office setting.

  • Alabama

    Alabama · 45520

    Office

    $149.12

    Facility

    $34.56

    $33.02 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 45520

    Office

    $146.63

    Facility

    $34.16

    $35.51 lower than El Centro for the office setting.

  • Arizona

    Arizona · 45520

    Office

    $163.74

    Facility

    $36.87

    $18.40 lower than El Centro for the office setting.

  • Colorado

    Colorado · 45520

    Office

    $177.87

    Facility

    $38.56

    $4.27 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 45520

    Office

    $180.95

    Facility

    $39.93

    $1.19 lower than El Centro for the office setting.

  • Delaware

    Delaware · 45520

    Office

    $166.75

    Facility

    $37.39

    $15.39 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 45520

    Office

    $172.49

    Facility

    $39.86

    $9.65 lower than El Centro for the office setting.

  • Rest Of Florida

    Florida · 45520

    Office

    $163.33

    Facility

    $38.15

    $18.81 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 45520

    Office

    $171.57

    Facility

    $38.54

    $10.57 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 45520

    Office

    $153.11

    Facility

    $36.32

    $29.03 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 45520

    Office

    $188.01

    Facility

    $39.14

    $5.87 higher than El Centro for the office setting.

  • Iowa

    Iowa · 45520

    Office

    $154.66

    Facility

    $34.86

    $27.48 lower than El Centro for the office setting.

  • Idaho

    Idaho · 45520

    Office

    $155.58

    Facility

    $35.12

    $26.56 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 45520

    Office

    $159.18

    Facility

    $38.72

    $22.96 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 45520

    Office

    $157.09

    Facility

    $37.55

    $25.05 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 45520

    Office

    $174.61

    Facility

    $40.14

    $7.53 lower than El Centro for the office setting.

  • Indiana

    Indiana · 45520

    Office

    $156.65

    Facility

    $35.27

    $25.49 lower than El Centro for the office setting.

  • Kansas

    Kansas · 45520

    Office

    $153.28

    Facility

    $34.92

    $28.86 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 45520

    Office

    $152.01

    Facility

    $35.62

    $30.13 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 45520

    Office

    $160.24

    Facility

    $37.04

    $21.90 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 45520

    Office

    $151.52

    Facility

    $35.65

    $30.62 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 45520

    Office

    $197.93

    Facility

    $41.59

    $15.79 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45520

    Office

    $176.35

    Facility

    $38.48

    $5.79 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45520

    Office

    $180.34

    Facility

    $39.85

    $1.80 lower than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 45520

    Office

    $170.44

    Facility

    $37.94

    $11.70 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 45520

    Office

    $155.93

    Facility

    $35.47

    $26.21 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 45520

    Office

    $166.48

    Facility

    $36.72

    $15.66 lower than El Centro for the office setting.

  • Detroit

    Michigan · 45520

    Office

    $165.09

    Facility

    $38.74

    $17.05 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 45520

    Office

    $156.07

    Facility

    $36.53

    $26.07 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 45520

    Office

    $171.33

    Facility

    $36.60

    $10.81 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 45520

    Office

    $159.57

    Facility

    $36.63

    $22.57 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 45520

    Office

    $161.56

    Facility

    $36.91

    $20.58 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 45520

    Office

    $148.15

    Facility

    $35.29

    $33.99 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 45520

    Office

    $147.45

    Facility

    $34.72

    $34.69 lower than El Centro for the office setting.

  • Montana**

    Montana · 45520

    Office

    $168.67

    Facility

    $37.74

    $13.47 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 45520

    Office

    $157.89

    Facility

    $35.74

    $24.25 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 45520

    Office

    $167.29

    Facility

    $36.35

    $14.85 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 45520

    Office

    $155.80

    Facility

    $34.95

    $26.34 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 45520

    Office

    $174.46

    Facility

    $38.16

    $7.68 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 45520

    Office

    $193.70

    Facility

    $41.82

    $11.56 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 45520

    Office

    $183.27

    Facility

    $40.29

    $1.13 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 45520

    Office

    $156.84

    Facility

    $36.77

    $25.30 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 45520

    Office

    $168.43

    Facility

    $37.37

    $13.71 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45520

    Office

    $199.86

    Facility

    $44.18

    $17.72 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45520

    Office

    $184.07

    Facility

    $40.70

    $1.93 higher than El Centro for the office setting.

  • Queens

    New York · 45520

    Office

    $197.85

    Facility

    $43.09

    $15.71 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 45520

    Office

    $160.57

    Facility

    $36.18

    $21.57 lower than El Centro for the office setting.

  • Ohio

    Ohio · 45520

    Office

    $155.79

    Facility

    $36.25

    $26.35 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 45520

    Office

    $152.29

    Facility

    $35.36

    $29.85 lower than El Centro for the office setting.

  • Portland

    Oregon · 45520

    Office

    $184.83

    Facility

    $39.36

    $2.69 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 45520

    Office

    $167.39

    Facility

    $36.98

    $14.75 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45520

    Office

    $175.53

    Facility

    $39.23

    $6.61 lower than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45520

    Office

    $156.39

    Facility

    $36.19

    $25.75 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 45520

    Office

    $170.27

    Facility

    $37.90

    $11.87 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 45520

    Office

    $173.66

    Facility

    $38.41

    $8.48 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 45520

    Office

    $157.05

    Facility

    $36.07

    $25.09 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 45520

    Office

    $167.12

    Facility

    $36.19

    $15.02 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 45520

    Office

    $154.10

    Facility

    $35.08

    $28.04 lower than El Centro for the office setting.

  • Austin

    Texas · 45520

    Office

    $177.05

    Facility

    $38.52

    $5.09 lower than El Centro for the office setting.

  • Beaumont

    Texas · 45520

    Office

    $155.16

    Facility

    $36.01

    $26.98 lower than El Centro for the office setting.

  • Brazoria

    Texas · 45520

    Office

    $166.97

    Facility

    $37.22

    $15.17 lower than El Centro for the office setting.

  • Dallas

    Texas · 45520

    Office

    $167.91

    Facility

    $37.50

    $14.23 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 45520

    Office

    $166.46

    Facility

    $37.36

    $15.68 lower than El Centro for the office setting.

  • Galveston

    Texas · 45520

    Office

    $167.38

    Facility

    $37.36

    $14.76 lower than El Centro for the office setting.

  • Houston

    Texas · 45520

    Office

    $168.66

    Facility

    $38.64

    $13.48 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 45520

    Office

    $160.88

    Facility

    $36.63

    $21.26 lower than El Centro for the office setting.

  • Utah

    Utah · 45520

    Office

    $159.54

    Facility

    $36.46

    $22.60 lower than El Centro for the office setting.

  • Virginia

    Virginia · 45520

    Office

    $165.47

    Facility

    $36.76

    $16.67 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45520

    Office

    $170.27

    Facility

    $37.90

    $11.87 lower than El Centro for the office setting.

  • Vermont

    Vermont · 45520

    Office

    $166.04

    Facility

    $36.41

    $16.10 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 45520

    Office

    $176.21

    Facility

    $38.34

    $5.93 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 45520

    Office

    $202.81

    Facility

    $42.16

    $20.67 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 45520

    Office

    $160.83

    Facility

    $35.40

    $21.31 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 45520

    Office

    $150.25

    Facility

    $36.48

    $31.89 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 45520

    Office

    $168.07

    Facility

    $37.14

    $14.07 lower than El Centro for the office setting.

See how rates vary across the country

45520 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$146.63

$208.63

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$186.281
AL$149.121
AR$146.631
AZ$163.741
CA$182.13–$235.1229
CO$177.871
CT$180.951
DC$196.311
DE$166.751
FL$163.33–$178.333
GA$153.11–$171.572
GU$188.011
HI$188.011
IA$154.661
ID$155.581
IL$157.09–$174.614
IN$156.651
KS$153.281
KY$152.011
LA$151.52–$160.242
MA$176.35–$197.932
MD$170.44–$196.313
ME$155.93–$166.482
MI$156.07–$165.092
MN$171.331
MO$148.15–$161.563
MS$147.451
MT$168.671
NC$157.891
ND$167.291
NE$155.801
NH$174.461
NJ$183.27–$193.702
NM$156.841
NV$168.431
NY$160.57–$199.865
OH$155.791
OK$152.291
OR$167.39–$184.832
PA$156.39–$175.532
PR$170.271
RI$173.661
SC$157.051
SD$167.121
TN$154.101
TX$155.16–$177.058
UT$159.541
VA$165.47–$196.312
VI$170.271
VT$166.041
WA$176.21–$202.812
WI$160.831
WV$150.251
WY$168.071

Explore 45520 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 45520 in El Centro, the physician’s office rate is $182.14 and the facility-setting rate is $38.64: a difference of $143.50.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 45520 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$200.35

$182.14 × 110% = $200.35

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.

Compare your contract offer →

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 45520 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

5,541

Code
45520
Physician work
0.54
Practice expense
4.44
Malpractice
0.07

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 45520 in El Centro
ComponentRVULocality factorAdjusted
Physician work0.54× 1.0170.5492
Practice expense4.44× 1.0964.8662
Malpractice0.07× 0.5410.0379
Total RVUs5.4533
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$182.14

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 45520 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.541.017
Practice expense4.441.096
Malpractice0.070.541

(0.54 × 1.017 + 4.44 × 1.096 + 0.07 × 0.541) × $33.4009 = $182.14

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.541.017
Practice expense0.521.096
Malpractice0.070.541

(0.54 × 1.017 + 0.52 × 1.096 + 0.07 × 0.541) × $33.4009 = $38.64

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

45520 · Office / nonfacility

$182.14

Effective 2026-10-01

The base rate is $17.33 higher than on 2025-10-01, moving from $164.81 to $182.14 (10.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $164.81changed to$182.14

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.55 changed to 0.54
    • Practice expense RVU 4.12 changed to 4.44
    • Malpractice RVU 0.06 changed to 0.07
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $164.81

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$182.14$38.64RVU26D
2026-07-01$182.14$38.64RVU26C
2026-04-01$182.14$38.64RVU26B
2026-01-01$182.14$38.64RVU26A
2025-10-01$164.81$40.71RVU25D
2025-07-01$164.81$40.71RVU25C
2025-04-01$164.81$40.71RVU25B
2025-01-01$164.81$40.71RVU25A

45520 billing questions

When should this code be chosen over a prolapse repair code?

Use it for a local treatment, such as injection therapy, rather than a formal abdominal or perineal repair. Select a repair code when the operative service matches that approach and repair.

What documentation supports reporting this service?

Document the rectal prolapse, the method used to treat it, and the work performed. The record should make clear that the service was not an abdominal or perineal repair.

Is same-day care included in the service?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can modifier 50 or an assistant-at-surgery claim be reported?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

How is this code affected when another procedure is 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.

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.

RVUs for 45520PPRRVU2026_Oct_nonQPP.csv, line 5,541 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet