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CMS RVU26D · Effective 2026-10-01

45005 in Merced

Office / nonfacility

$387.21

Base rate per service

Facility setting

$175.62

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 45005: Rectal submucosal abscess drainage

Reports incision and drainage of an abscess beneath the rectal mucosa, rather than drainage of a pelvic or perirectal collection.

Code 45005 describes incision and drainage of an abscess located beneath the rectal mucosa. A colorectal or general surgeon typically accesses the collection through the rectum, incises the involved area, and evacuates the abscess. The operative note should identify the submucosal rectal location and document the incision and drainage performed; a pelvic or perirectal collection is not this service.

Report this code for the submucosal rectal abscess, not solely because an abscess is near the rectum. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Report the service once for the rectal site; modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 45005

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 RVU1.97 · 18%
  • Practice expense (office) RVU8.50 · 77%
  • Malpractice RVU0.51 · 5%

43

Medicare services in 2024 · #5452 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.

45005 compared with similar codes

Office rates for Merced, from the same CMS release.

45020

Abscess drainage

Perirectal, transperineal approach

No office rate

Use 45005 for an abscess beneath the rectal mucosa. Use 45020 for a perirectal abscess drained through a transrectal approach.

45000

Pelvic abscess drainage

Transrectal approach

No office rate

45000 describes drainage of a pelvic abscess by a transrectal, transvaginal, or percutaneous approach; 45005 is specific to a submucosal abscess in the rectum.

46040

Abscess drainage

Ischiorectal or intramural

$654.51

46040 is for an ischiorectal or perirectal abscess. Choose 45005 when the documented collection is submucosal within the rectum.

46050

Perianal abscess drainage

Superficial abscess

$285.18

46050 is for a superficial perianal abscess. Code 45005 is for an abscess beneath the rectal mucosa.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 45005 is $388.59—$1.38 higher than the $387.21 rate in Merced. Both use the same code, release and participation basis.

45005 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $387.21

  2. Bakersfield

    $388.59

    $1.38 higher than Merced

  3. Chico

    $387.21

    The same base rate than Merced

  4. El Centro

    $387.30

    $0.09 higher than Merced

  5. Fresno

    $387.21

    The same base rate than Merced

  6. Hanford-Corcoran

    $387.21

    The same base rate than Merced

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

    $415.67

    $28.46 higher than Merced

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, 45005 ranges from $318.45 in Arkansas to $491.56 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

  • Madera

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Modesto

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Napa

    California · 45005

    Office

    $452.79

    Facility

    $198.34

    $65.58 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 45005

    Office

    $413.83

    Facility

    $185.64

    $26.62 higher than Merced for the office setting.

  • Redding

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 45005

    Office

    $392.68

    Facility

    $181.09

    $5.47 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 45005

    Office

    $407.48

    Facility

    $182.96

    $20.27 higher than Merced for the office setting.

  • Salinas

    California · 45005

    Office

    $406.02

    Facility

    $182.27

    $18.81 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 45005

    Office

    $416.56

    Facility

    $185.66

    $29.35 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 45005

    Office

    $480.18

    Facility

    $207.97

    $92.97 higher than Merced for the office setting.

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

    California · 45005

    Office

    $479.60

    Facility

    $207.39

    $92.39 higher than Merced for the office setting.

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

    California · 45005

    Office

    $491.56

    Facility

    $213.17

    $104.35 higher than Merced for the office setting.

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

    California · 45005

    Office

    $489.20

    Facility

    $210.81

    $101.99 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 45005

    Office

    $399.42

    Facility

    $179.53

    $12.21 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 45005

    Office

    $421.26

    Facility

    $186.70

    $34.05 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 45005

    Office

    $407.81

    Facility

    $182.70

    $20.60 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 45005

    Office

    $425.54

    Facility

    $188.47

    $38.33 higher than Merced for the office setting.

  • Stockton

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 45005

    Office

    $451.95

    Facility

    $197.50

    $64.74 higher than Merced for the office setting.

  • Visalia

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 45005

    Office

    $387.21

    Facility

    $175.62

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 45005

    Office

    $422.76

    Facility

    $195.33

    $35.55 higher than Merced for the office setting.

  • Miami

    Florida · 45005

    Office

    $404.43

    Facility

    $203.46

    $17.22 higher than Merced for the office setting.

  • Chicago

    Illinois · 45005

    Office

    $390.68

    Facility

    $196.66

    $3.47 higher than Merced for the office setting.

  • Manhattan

    New York · 45005

    Office

    $426.93

    Facility

    $202.60

    $39.72 higher than Merced for the office setting.

  • Alaska*

    Alaska · 45005

    Office

    $410.45

    Facility

    $204.84

    $23.24 higher than Merced for the office setting.

  • Alabama

    Alabama · 45005

    Office

    $323.86

    Facility

    $154.94

    $63.35 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 45005

    Office

    $318.45

    Facility

    $152.61

    $68.76 lower than Merced for the office setting.

  • Arizona

    Arizona · 45005

    Office

    $355.49

    Facility

    $168.42

    $31.72 lower than Merced for the office setting.

  • Colorado

    Colorado · 45005

    Office

    $381.97

    Facility

    $176.56

    $5.24 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 45005

    Office

    $393.50

    Facility

    $185.57

    $6.29 higher than Merced for the office setting.

  • Delaware

    Delaware · 45005

    Office

    $361.94

    Facility

    $171.20

    $25.27 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 45005

    Office

    $384.20

    Facility

    $188.63

    $3.01 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 45005

    Office

    $362.82

    Facility

    $178.26

    $24.39 lower than Merced for the office setting.

  • Atlanta

    Georgia · 45005

    Office

    $374.91

    Facility

    $178.76

    $12.30 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 45005

    Office

    $339.35

    Facility

    $167.14

    $47.86 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 45005

    Office

    $398.47

    Facility

    $178.96

    $11.26 higher than Merced for the office setting.

  • Iowa

    Iowa · 45005

    Office

    $332.34

    Facility

    $155.69

    $54.87 lower than Merced for the office setting.

  • Idaho

    Idaho · 45005

    Office

    $335.05

    Facility

    $157.44

    $52.16 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 45005

    Office

    $361.30

    Facility

    $183.69

    $25.91 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 45005

    Office

    $351.63

    Facility

    $175.37

    $35.58 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 45005

    Office

    $388.02

    Facility

    $189.75

    $0.81 higher than Merced for the office setting.

  • Indiana

    Indiana · 45005

    Office

    $337.26

    Facility

    $158.30

    $49.95 lower than Merced for the office setting.

  • Kansas

    Kansas · 45005

    Office

    $331.04

    Facility

    $156.51

    $56.17 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 45005

    Office

    $333.78

    Facility

    $162.15

    $53.43 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 45005

    Office

    $352.31

    Facility

    $170.64

    $34.90 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 45005

    Office

    $333.38

    Facility

    $162.52

    $53.83 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 45005

    Office

    $422.64

    Facility

    $192.13

    $35.43 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 45005

    Office

    $379.38

    Facility

    $176.09

    $7.83 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 45005

    Office

    $392.56

    Facility

    $185.41

    $5.35 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 45005

    Office

    $369.41

    Facility

    $174.04

    $17.80 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 45005

    Office

    $337.59

    Facility

    $159.98

    $49.62 lower than Merced for the office setting.

  • Southern Maine

    Maine · 45005

    Office

    $357.90

    Facility

    $166.58

    $29.31 lower than Merced for the office setting.

  • Detroit

    Michigan · 45005

    Office

    $368.49

    Facility

    $182.19

    $18.72 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 45005

    Office

    $344.24

    Facility

    $167.98

    $42.97 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 45005

    Office

    $362.98

    Facility

    $164.33

    $24.23 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 45005

    Office

    $349.03

    Facility

    $167.75

    $38.18 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 45005

    Office

    $353.15

    Facility

    $169.36

    $34.06 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 45005

    Office

    $327.12

    Facility

    $160.70

    $60.09 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 45005

    Office

    $322.83

    Facility

    $156.61

    $64.38 lower than Merced for the office setting.

  • Montana**

    Montana · 45005

    Office

    $366.71

    Facility

    $173.65

    $20.50 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 45005

    Office

    $341.57

    Facility

    $161.45

    $45.64 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 45005

    Office

    $356.62

    Facility

    $163.57

    $30.59 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 45005

    Office

    $334.29

    Facility

    $156.09

    $52.92 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 45005

    Office

    $376.25

    Facility

    $175.28

    $10.96 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 45005

    Office

    $417.47

    Facility

    $193.52

    $30.26 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 45005

    Office

    $397.15

    Facility

    $186.33

    $9.94 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 45005

    Office

    $346.60

    Facility

    $169.57

    $40.61 lower than Merced for the office setting.

  • Nevada**

    Nevada · 45005

    Office

    $364.18

    Facility

    $170.93

    $23.03 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 45005

    Office

    $439.21

    Facility

    $209.67

    $52.00 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 45005

    Office

    $400.25

    Facility

    $188.85

    $13.04 higher than Merced for the office setting.

  • Queens

    New York · 45005

    Office

    $430.15

    Facility

    $201.96

    $42.94 higher than Merced for the office setting.

  • Rest Of New York

    New York · 45005

    Office

    $347.49

    Facility

    $164.08

    $39.72 lower than Merced for the office setting.

  • Ohio

    Ohio · 45005

    Office

    $342.18

    Facility

    $165.92

    $45.03 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 45005

    Office

    $332.57

    Facility

    $160.16

    $54.64 lower than Merced for the office setting.

  • Portland

    Oregon · 45005

    Office

    $394.95

    Facility

    $180.46

    $7.74 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 45005

    Office

    $360.55

    Facility

    $168.26

    $26.66 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 45005

    Office

    $382.85

    Facility

    $181.88

    $4.36 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 45005

    Office

    $342.52

    Facility

    $165.30

    $44.69 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 45005

    Office

    $369.61

    Facility

    $174.43

    $17.60 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 45005

    Office

    $375.52

    Facility

    $176.09

    $11.69 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 45005

    Office

    $342.61

    Facility

    $164.22

    $44.60 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 45005

    Office

    $355.43

    Facility

    $162.37

    $31.78 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 45005

    Office

    $333.02

    Facility

    $157.53

    $54.19 lower than Merced for the office setting.

  • Austin

    Texas · 45005

    Office

    $381.40

    Facility

    $177.14

    $5.81 lower than Merced for the office setting.

  • Beaumont

    Texas · 45005

    Office

    $339.98

    Facility

    $164.30

    $47.23 lower than Merced for the office setting.

  • Brazoria

    Texas · 45005

    Office

    $360.97

    Facility

    $169.65

    $26.24 lower than Merced for the office setting.

  • Dallas

    Texas · 45005

    Office

    $363.78

    Facility

    $171.49

    $23.43 lower than Merced for the office setting.

  • Fort Worth

    Texas · 45005

    Office

    $361.16

    Facility

    $170.81

    $26.05 lower than Merced for the office setting.

  • Galveston

    Texas · 45005

    Office

    $362.35

    Facility

    $170.65

    $24.86 lower than Merced for the office setting.

  • Houston

    Texas · 45005

    Office

    $371.69

    Facility

    $179.98

    $15.52 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 45005

    Office

    $350.61

    Facility

    $167.40

    $36.60 lower than Merced for the office setting.

  • Utah

    Utah · 45005

    Office

    $347.97

    Facility

    $166.50

    $39.24 lower than Merced for the office setting.

  • Virginia

    Virginia · 45005

    Office

    $356.91

    Facility

    $167.13

    $30.30 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 45005

    Office

    $369.61

    Facility

    $174.43

    $17.60 lower than Merced for the office setting.

  • Vermont

    Vermont · 45005

    Office

    $355.49

    Facility

    $164.36

    $31.72 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 45005

    Office

    $378.57

    Facility

    $175.28

    $8.64 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 45005

    Office

    $431.36

    Facility

    $194.48

    $44.15 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 45005

    Office

    $343.03

    Facility

    $158.08

    $44.18 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 45005

    Office

    $336.89

    Facility

    $169.13

    $50.32 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 45005

    Office

    $362.31

    Facility

    $169.26

    $24.90 lower than Merced for the office setting.

See how rates vary across the country

45005 · 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.

$318.45

$439.39

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$410.451
AL$323.861
AR$318.451
AZ$355.491
CA$387.21–$491.5629
CO$381.971
CT$393.501
DC$422.761
DE$361.941
FL$362.82–$404.433
GA$339.35–$374.912
GU$398.471
HI$398.471
IA$332.341
ID$335.051
IL$351.63–$390.684
IN$337.261
KS$331.041
KY$333.781
LA$333.38–$352.312
MA$379.38–$422.642
MD$369.41–$422.763
ME$337.59–$357.902
MI$344.24–$368.492
MN$362.981
MO$327.12–$353.153
MS$322.831
MT$366.711
NC$341.571
ND$356.621
NE$334.291
NH$376.251
NJ$397.15–$417.472
NM$346.601
NV$364.181
NY$347.49–$439.215
OH$342.181
OK$332.571
OR$360.55–$394.952
PA$342.52–$382.852
PR$369.611
RI$375.521
SC$342.611
SD$355.431
TN$333.021
TX$339.98–$381.408
UT$347.971
VA$356.91–$422.762
VI$369.611
VT$355.491
WA$378.57–$431.362
WI$343.031
WV$336.891
WY$362.311

Explore 45005 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 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 45005 in Merced, the physician’s office rate is $387.21 and the facility-setting rate is $175.62: a difference of $211.59.

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 45005 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$425.93

$387.21 × 110% = $425.93

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.

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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 45005 in Merced.

PPRRVU2026_Oct_nonQPP.csv

5,460

Code
45005
Physician work
1.97
Practice expense
8.50
Malpractice
0.51

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 45005 in Merced
ComponentRVULocality factorAdjusted
Physician work1.97× 1.0172.0035
Practice expense8.50× 1.0969.3160
Malpractice0.51× 0.5360.2734
Total RVUs11.5929
Conversion factor× 33.4009

Office / nonfacility rate, Merced$387.21

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

Open 45005 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.971.017
Practice expense8.51.096
Malpractice0.510.536

(1.97 × 1.017 + 8.5 × 1.096 + 0.51 × 0.536) × $33.4009 = $387.21

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.971.017
Practice expense2.721.096
Malpractice0.510.536

(1.97 × 1.017 + 2.72 × 1.096 + 0.51 × 0.536) × $33.4009 = $175.62

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

45005 · Office / nonfacility

$387.21

Effective 2026-10-01

The base rate is $62.82 higher than on 2025-10-01, moving from $324.39 to $387.21 (19.4%).

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

    $324.39changed to$387.21

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.02 changed to 1.97
    • Practice expense RVU 7.04 changed to 8.50
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $324.39

    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$387.21$175.62RVU26D
2026-07-01$387.21$175.62RVU26C
2026-04-01$387.21$175.62RVU26B
2026-01-01$387.21$175.62RVU26A
2025-10-01$324.39$167.06RVU25D
2025-07-01$324.39$167.06RVU25C
2025-04-01$324.39$167.06RVU25B
2025-01-01$324.39$167.06RVU25A

45005 billing questions

How does 45005 differ from 45020?

45005 is for an abscess beneath the rectal mucosa. Code 45020 describes drainage of a perirectal abscess by a transrectal approach.

What documentation supports 45005?

Document the abscess location within the rectal wall, the incision, and drainage performed. The record should distinguish a submucosal collection from a pelvic, perirectal, or superficial perianal abscess.

Are postoperative visits separately reported?

Related postoperative visits for 10 days are included in the global period.

Can modifier 50 be used?

No. Report the service once for the rectal site; the anatomy makes modifier 50 inappropriate.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are reduced to 50% under the standard multiple procedure rule.

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 45005PPRRVU2026_Oct_nonQPP.csv, line 5,460 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet