No office rate
Choose 45397 when the laparoscopic operation creates an ileal pouch with an ileoanal connection. Choose 45395 for laparoscopic proctectomy with colostomy instead.
On this page
CMS RVU26D · Effective 2026-10-01
45397 in Salinas
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1970.35
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 45397: Laparoscopic proctectomy with ileal pouch
Reports laparoscopic complete proctectomy with creation of an ileal pouch and connection to the anus, with or without a diverting ileostomy.
A colorectal surgeon uses a laparoscopic approach to remove the rectum and create an ileal reservoir, typically an S- or J-shaped pouch, connected to the anus. This restorative operation may be performed for conditions such as ulcerative colitis or familial adenomatous polyposis. A diverting ileostomy may also be created to protect the pouch connection; it is included in the service when performed.
Select this code when the operative report supports laparoscopic complete proctectomy, ileal pouch construction, and ileoanal anastomosis. The pouch and anastomosis distinguish it from laparoscopic proctectomy with colostomy. The service has a 90-day global period, including 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. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this unpaired anatomy.
CMS billing rules for 45397
- 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 RVU35.59 · 61%
- Practice expense (office) RVU16.39 · 28%
- Malpractice RVU6.16 · 11%
131
Medicare services in 2024 · #4661 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.
45397 compared with similar codes
Office rates for Salinas, from the same CMS release.
No office rate
45113 describes the open approach to complete proctectomy with ileal pouch reconstruction; 45397 describes the laparoscopic approach.
No office rate
44212 is for laparoscopic total colectomy with proctectomy and ileal pouch reconstruction. Use 45397 when the documented procedure is proctectomy with pouch creation rather than total colectomy.
The same code, a different location
How does Salinas compare?
45397 across payment areas
Same release and payment basis · bars start at $0
Salinas · 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.
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
Madera
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Merced
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Modesto
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Napa
California · 45397
Office
Unavailable
Facility
$2089.68
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 45397
Office
Unavailable
Facility
$1997.28
No comparable office rate is available.
Redding
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Rest Of California
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 45397
Office
Unavailable
Facility
$1985.63
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 45397
Office
Unavailable
Facility
$1978.49
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 45397
Office
Unavailable
Facility
$1990.66
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45397
Office
Unavailable
Facility
$2168.00
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45397
Office
Unavailable
Facility
$2161.00
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45397
Office
Unavailable
Facility
$2219.19
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45397
Office
Unavailable
Facility
$2190.59
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 45397
Office
Unavailable
Facility
$1942.76
No comparable office rate is available.
Santa Cruz-Watsonville
California · 45397
Office
Unavailable
Facility
$1989.12
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 45397
Office
Unavailable
Facility
$1970.62
No comparable office rate is available.
Santa Rosa-Petaluma
California · 45397
Office
Unavailable
Facility
$2006.94
No comparable office rate is available.
Stockton
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Vallejo
California · 45397
Office
Unavailable
Facility
$2079.59
No comparable office rate is available.
Visalia
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Yuba City
California · 45397
Office
Unavailable
Facility
$1919.22
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 45397
Office
Unavailable
Facility
$2126.81
No comparable office rate is available.
Miami
Florida · 45397
Office
Unavailable
Facility
$2278.96
No comparable office rate is available.
Chicago
Illinois · 45397
Office
Unavailable
Facility
$2219.43
No comparable office rate is available.
Manhattan
New York · 45397
Office
Unavailable
Facility
$2227.26
No comparable office rate is available.
Alaska*
Alaska · 45397
Office
Unavailable
Facility
$2479.50
No comparable office rate is available.
Alabama
Alabama · 45397
Office
Unavailable
Facility
$1784.20
No comparable office rate is available.
Arkansas
Arkansas · 45397
Office
Unavailable
Facility
$1764.95
No comparable office rate is available.
Arizona
Arizona · 45397
Office
Unavailable
Facility
$1895.33
No comparable office rate is available.
Colorado
Colorado · 45397
Office
Unavailable
Facility
$1946.17
No comparable office rate is available.
Connecticut
Connecticut · 45397
Office
Unavailable
Facility
$2051.06
No comparable office rate is available.
Delaware
Delaware · 45397
Office
Unavailable
Facility
$1920.52
No comparable office rate is available.
Fort Lauderdale
Florida · 45397
Office
Unavailable
Facility
$2115.29
No comparable office rate is available.
Rest Of Florida
Florida · 45397
Office
Unavailable
Facility
$2021.33
No comparable office rate is available.
Atlanta
Georgia · 45397
Office
Unavailable
Facility
$1995.61
No comparable office rate is available.
Rest Of Georgia
Georgia · 45397
Office
Unavailable
Facility
$1922.31
No comparable office rate is available.
Hawaii, Guam
Hawaii · 45397
Office
Unavailable
Facility
$1930.31
No comparable office rate is available.
Iowa
Iowa · 45397
Office
Unavailable
Facility
$1771.33
No comparable office rate is available.
Idaho
Idaho · 45397
Office
Unavailable
Facility
$1789.70
No comparable office rate is available.
East St. Louis
Illinois · 45397
Office
Unavailable
Facility
$2106.76
No comparable office rate is available.
Rest Of Illinois
Illinois · 45397
Office
Unavailable
Facility
$2010.14
No comparable office rate is available.
Suburban Chicago
Illinois · 45397
Office
Unavailable
Facility
$2123.87
No comparable office rate is available.
Indiana
Indiana · 45397
Office
Unavailable
Facility
$1796.21
No comparable office rate is available.
Kansas
Kansas · 45397
Office
Unavailable
Facility
$1787.32
No comparable office rate is available.
Kentucky
Kentucky · 45397
Office
Unavailable
Facility
$1863.67
No comparable office rate is available.
New Orleans
Louisiana · 45397
Office
Unavailable
Facility
$1937.61
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 45397
Office
Unavailable
Facility
$1870.33
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 45397
Office
Unavailable
Facility
$2074.24
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 45397
Office
Unavailable
Facility
$1948.20
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 45397
Office
Unavailable
Facility
$2049.67
No comparable office rate is available.
Rest Of Maryland
Maryland · 45397
Office
Unavailable
Facility
$1943.51
No comparable office rate is available.
Rest Of Maine
Maine · 45397
Office
Unavailable
Facility
$1820.36
No comparable office rate is available.
Southern Maine
Maine · 45397
Office
Unavailable
Facility
$1861.08
No comparable office rate is available.
Detroit
Michigan · 45397
Office
Unavailable
Facility
$2063.91
No comparable office rate is available.
Rest Of Michigan
Michigan · 45397
Office
Unavailable
Facility
$1920.84
No comparable office rate is available.
Minnesota
Minnesota · 45397
Office
Unavailable
Facility
$1812.96
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 45397
Office
Unavailable
Facility
$1903.80
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 45397
Office
Unavailable
Facility
$1916.06
No comparable office rate is available.
Rest Of Missouri
Missouri · 45397
Office
Unavailable
Facility
$1861.03
No comparable office rate is available.
Mississippi
Mississippi · 45397
Office
Unavailable
Facility
$1812.13
No comparable office rate is available.
Montana**
Montana · 45397
Office
Unavailable
Facility
$1941.52
No comparable office rate is available.
North Carolina
North Carolina · 45397
Office
Unavailable
Facility
$1830.97
No comparable office rate is available.
North Dakota**
North Dakota · 45397
Office
Unavailable
Facility
$1819.71
No comparable office rate is available.
Nebraska
Nebraska · 45397
Office
Unavailable
Facility
$1771.80
No comparable office rate is available.
New Hampshire
New Hampshire · 45397
Office
Unavailable
Facility
$1938.65
No comparable office rate is available.
Northern Nj
New Jersey · 45397
Office
Unavailable
Facility
$2118.40
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 45397
Office
Unavailable
Facility
$2059.80
No comparable office rate is available.
New Mexico
New Mexico · 45397
Office
Unavailable
Facility
$1937.85
No comparable office rate is available.
Nevada**
Nevada · 45397
Office
Unavailable
Facility
$1908.12
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 45397
Office
Unavailable
Facility
$2297.80
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 45397
Office
Unavailable
Facility
$2090.64
No comparable office rate is available.
Queens
New York · 45397
Office
Unavailable
Facility
$2208.58
No comparable office rate is available.
Rest Of New York
New York · 45397
Office
Unavailable
Facility
$1853.45
No comparable office rate is available.
Ohio
Ohio · 45397
Office
Unavailable
Facility
$1895.95
No comparable office rate is available.
Oklahoma
Oklahoma · 45397
Office
Unavailable
Facility
$1837.47
No comparable office rate is available.
Portland
Oregon · 45397
Office
Unavailable
Facility
$1969.04
No comparable office rate is available.
Rest Of Oregon
Oregon · 45397
Office
Unavailable
Facility
$1878.63
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 45397
Office
Unavailable
Facility
$2025.48
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 45397
Office
Unavailable
Facility
$1885.72
No comparable office rate is available.
Puerto Rico
Puerto Rico · 45397
Office
Unavailable
Facility
$1944.86
No comparable office rate is available.
Rhode Island
Rhode Island · 45397
Office
Unavailable
Facility
$1960.36
No comparable office rate is available.
South Carolina
South Carolina · 45397
Office
Unavailable
Facility
$1869.46
No comparable office rate is available.
South Dakota**
South Dakota · 45397
Office
Unavailable
Facility
$1805.31
No comparable office rate is available.
Tennessee
Tennessee · 45397
Office
Unavailable
Facility
$1796.85
No comparable office rate is available.
Austin
Texas · 45397
Office
Unavailable
Facility
$1952.60
No comparable office rate is available.
Beaumont
Texas · 45397
Office
Unavailable
Facility
$1878.05
No comparable office rate is available.
Brazoria
Texas · 45397
Office
Unavailable
Facility
$1901.25
No comparable office rate is available.
Dallas
Texas · 45397
Office
Unavailable
Facility
$1921.22
No comparable office rate is available.
Fort Worth
Texas · 45397
Office
Unavailable
Facility
$1918.42
No comparable office rate is available.
Galveston
Texas · 45397
Office
Unavailable
Facility
$1912.22
No comparable office rate is available.
Houston
Texas · 45397
Office
Unavailable
Facility
$2024.97
No comparable office rate is available.
Rest Of Texas
Texas · 45397
Office
Unavailable
Facility
$1894.05
No comparable office rate is available.
Utah
Utah · 45397
Office
Unavailable
Facility
$1888.10
No comparable office rate is available.
Virginia
Virginia · 45397
Office
Unavailable
Facility
$1872.13
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 45397
Office
Unavailable
Facility
$1944.86
No comparable office rate is available.
Vermont
Vermont · 45397
Office
Unavailable
Facility
$1834.81
No comparable office rate is available.
Rest Of Washington
Washington · 45397
Office
Unavailable
Facility
$1937.22
No comparable office rate is available.
Seattle (King Cnty)
Washington · 45397
Office
Unavailable
Facility
$2087.98
No comparable office rate is available.
Wisconsin
Wisconsin · 45397
Office
Unavailable
Facility
$1776.56
No comparable office rate is available.
West Virginia
West Virginia · 45397
Office
Unavailable
Facility
$1958.89
No comparable office rate is available.
Wyoming**
Wyoming · 45397
Office
Unavailable
Facility
$1888.43
No comparable office rate is available.
See how rates vary across the country
45397 · 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?
Salinas 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 45397 in Salinas. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2167.39
$1970.35 × 110% = $2167.39
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 45397 in Salinas.
PPRRVU2026_Oct_nonQPP.csv
5,529
- Code
- 45397
- Physician work
- 35.59
- Practice expense
- 16.39
- Malpractice
- 6.16
GPCI2026.csv
22
- Locality
- Salinas
- Physician work
- 1.031
- Practice expense
- 1.159
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.59 | × 1.031 | 36.6933 |
| Practice expense | 16.39 | × 1.159 | 18.9960 |
| Malpractice | 6.16 | × 0.536 | 3.3018 |
| Total RVUs | 58.9911 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Salinas$1970.35
Open 45397 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.59 | 1.031 |
| Practice expense | 16.39 | 1.159 |
| Malpractice | 6.16 | 0.536 |
(35.59 × 1.031 + 16.39 × 1.159 + 6.16 × 0.536) × $33.4009 = $1970.35
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
45397 · 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 | $1970.35 | RVU26D |
| 2026-07-01 | Not available in this setting | $1970.35 | RVU26C |
| 2026-04-01 | Not available in this setting | $1970.35 | RVU26B |
| 2026-01-01 | Not available in this setting | $1970.35 | RVU26A |
| 2025-10-01 | Not available in this setting | $2109.53 | RVU25D |
| 2025-07-01 | Not available in this setting | $2109.53 | RVU25C |
| 2025-04-01 | Not available in this setting | $2109.53 | RVU25B |
| 2025-01-01 | Not available in this setting | $2109.53 | RVU25A |
45397 billing questions
How does this differ from 45395?
45397 includes creation of an ileal pouch and an ileoanal connection. 45395 describes laparoscopic proctectomy with colostomy rather than pouch reconstruction.
Is a diverting ileostomy included?
Yes. The service includes a diverting ileostomy when performed, so its presence does not change the choice of 45397.
What operative details support 45397?
Document the laparoscopic approach, complete rectal removal, ileal reservoir construction, and ileoanal anastomosis. Note whether a diverting ileostomy was created.
Can modifier 50 be used?
No. The procedure involves unpaired anatomy, so modifier 50 is inappropriate.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
What is the postoperative global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,52645392,,Colonoscopy w/endoscopic fnb,A,,5.36,1.99,NA,1.99,,0.61,7.96,7.96,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52745393,,Colonoscopy w/decompression,A,,4.56,1.42,NA,1.42,,0.56,6.54,6.54,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52845395,,Lap removal of rectum,A,,32.18,15.69,NA,15.69,,6.00,53.87,53.87,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,52945397,,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
1901112,CA,61,REDDING,1.017,1.096,0.536
2001112,CA,62,RIVERSIDE-SAN BERNARDINO-ONTARIO,1.018,1.096,0.853
2101112,CA,63,SACRAMENTO-ROSEVILLE-FOLSOM,1.036,1.163,0.536
2201112,CA,64,SALINAS,1.031,1.159,0.536
2301182,CA,72,SAN DIEGO-CHULA VISTA-CARLSBAD,1.030,1.196,0.542
2401112,CA,05,SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY),1.095,1.410,0.425
2501112,CA,52,SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY),1.095,1.410,0.459