No office rate
Choose 45541 for a perineal repair; 45540 describes an abdominal approach.
On this page
CMS RVU26D · Effective 2026-10-01
45541 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$865.36
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 45541: Perineal rectal prolapse repair
Reports operative correction of rectal prolapse through a perineal approach, such as a Delorme-type repair performed by a colorectal or general surgeon.
CPT 45541 describes surgical correction of rectal prolapse through the perineum rather than through an abdominal approach. A colorectal or general surgeon may perform a Delorme-type operation, which can involve removing a sleeve of rectal mucosa and plicating the underlying muscle. The service is generally performed in an operating room for a patient with prolapse extending through the anus; the operative report should identify the perineal route and the corrective work performed.
Report the code when the documented operation matches perineal repair, not abdominal rectopexy or a distinct prolapse excision procedure. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this operation.
CMS billing rules for 45541
- 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 RVU14.48 · 54%
- Practice expense (office) RVU9.26 · 35%
- Malpractice RVU2.93 · 11%
215
Medicare services in 2024 · #4263 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.
45541 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
45550 describes abdominal prolapse repair with sigmoid resection. It is not the perineal repair represented by 45541.
No office rate
45130 represents perineal excision of rectal prolapse. Use 45541 when the documented service is repair rather than that excision procedure.
No office rate
45400 describes laparoscopic abdominal repair, while 45541 is for repair performed through a perineal approach.
The same code, a different location
How does Wyoming** compare?
45541 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming 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
Alabama
Alabama · 45541
Office
Unavailable
Facility
$809.67
No comparable office rate is available.
Arkansas
Arkansas · 45541
Office
Unavailable
Facility
$799.73
No comparable office rate is available.
Arizona
Arizona · 45541
Office
Unavailable
Facility
$867.12
No comparable office rate is available.
Bakersfield
California · 45541
Office
Unavailable
Facility
$891.42
No comparable office rate is available.
Chico
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
El Centro
California · 45541
Office
Unavailable
Facility
$883.80
No comparable office rate is available.
Fresno
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Hanford-Corcoran
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Madera
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Merced
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Modesto
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Napa
California · 45541
Office
Unavailable
Facility
$971.48
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 45541
Office
Unavailable
Facility
$923.74
No comparable office rate is available.
Redding
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Rest Of California
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 45541
Office
Unavailable
Facility
$914.81
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 45541
Office
Unavailable
Facility
$913.22
No comparable office rate is available.
Salinas
California · 45541
Office
Unavailable
Facility
$909.56
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 45541
Office
Unavailable
Facility
$921.11
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 45541
Office
Unavailable
Facility
$1010.61
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 45541
Office
Unavailable
Facility
$1007.29
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 45541
Office
Unavailable
Facility
$1035.30
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 45541
Office
Unavailable
Facility
$1021.70
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 45541
Office
Unavailable
Facility
$896.61
No comparable office rate is available.
Santa Cruz-Watsonville
California · 45541
Office
Unavailable
Facility
$922.05
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 45541
Office
Unavailable
Facility
$910.28
No comparable office rate is available.
Santa Rosa-Petaluma
California · 45541
Office
Unavailable
Facility
$930.42
No comparable office rate is available.
Stockton
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Vallejo
California · 45541
Office
Unavailable
Facility
$966.68
No comparable office rate is available.
Visalia
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Yuba City
California · 45541
Office
Unavailable
Facility
$883.31
No comparable office rate is available.
Colorado
Colorado · 45541
Office
Unavailable
Facility
$894.97
No comparable office rate is available.
Connecticut
Connecticut · 45541
Office
Unavailable
Facility
$944.84
No comparable office rate is available.
Delaware
Delaware · 45541
Office
Unavailable
Facility
$879.62
No comparable office rate is available.
Fort Lauderdale
Florida · 45541
Office
Unavailable
Facility
$973.90
No comparable office rate is available.
Rest Of Florida
Florida · 45541
Office
Unavailable
Facility
$926.42
No comparable office rate is available.
Atlanta
Georgia · 45541
Office
Unavailable
Facility
$916.87
No comparable office rate is available.
Rest Of Georgia
Georgia · 45541
Office
Unavailable
Facility
$876.19
No comparable office rate is available.
Hawaii, Guam
Hawaii · 45541
Office
Unavailable
Facility
$891.97
No comparable office rate is available.
Iowa
Iowa · 45541
Office
Unavailable
Facility
$805.50
No comparable office rate is available.
Idaho
Idaho · 45541
Office
Unavailable
Facility
$814.48
No comparable office rate is available.
East St. Louis
Illinois · 45541
Office
Unavailable
Facility
$965.29
No comparable office rate is available.
Rest Of Illinois
Illinois · 45541
Office
Unavailable
Facility
$918.99
No comparable office rate is available.
Suburban Chicago
Illinois · 45541
Office
Unavailable
Facility
$978.09
No comparable office rate is available.
Indiana
Indiana · 45541
Office
Unavailable
Facility
$817.92
No comparable office rate is available.
Kansas
Kansas · 45541
Office
Unavailable
Facility
$812.57
No comparable office rate is available.
Kentucky
Kentucky · 45541
Office
Unavailable
Facility
$848.15
No comparable office rate is available.
New Orleans
Louisiana · 45541
Office
Unavailable
Facility
$885.86
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 45541
Office
Unavailable
Facility
$851.12
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 45541
Office
Unavailable
Facility
$959.87
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 45541
Office
Unavailable
Facility
$895.07
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 45541
Office
Unavailable
Facility
$944.31
No comparable office rate is available.
Rest Of Maryland
Maryland · 45541
Office
Unavailable
Facility
$891.33
No comparable office rate is available.
Rest Of Maine
Maine · 45541
Office
Unavailable
Facility
$829.07
No comparable office rate is available.
Southern Maine
Maine · 45541
Office
Unavailable
Facility
$851.91
No comparable office rate is available.
Detroit
Michigan · 45541
Office
Unavailable
Facility
$947.11
No comparable office rate is available.
Rest Of Michigan
Michigan · 45541
Office
Unavailable
Facility
$876.52
No comparable office rate is available.
Minnesota
Minnesota · 45541
Office
Unavailable
Facility
$830.87
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 45541
Office
Unavailable
Facility
$869.68
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 45541
Office
Unavailable
Facility
$876.15
No comparable office rate is available.
Rest Of Missouri
Missouri · 45541
Office
Unavailable
Facility
$845.58
No comparable office rate is available.
Mississippi
Mississippi · 45541
Office
Unavailable
Facility
$822.27
No comparable office rate is available.
Montana**
Montana · 45541
Office
Unavailable
Facility
$890.61
No comparable office rate is available.
North Carolina
North Carolina · 45541
Office
Unavailable
Facility
$834.75
No comparable office rate is available.
North Dakota**
North Dakota · 45541
Office
Unavailable
Facility
$832.67
No comparable office rate is available.
Nebraska
Nebraska · 45541
Office
Unavailable
Facility
$806.11
No comparable office rate is available.
New Hampshire
New Hampshire · 45541
Office
Unavailable
Facility
$891.25
No comparable office rate is available.
Northern Nj
New Jersey · 45541
Office
Unavailable
Facility
$977.41
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 45541
Office
Unavailable
Facility
$948.10
No comparable office rate is available.
New Mexico
New Mexico · 45541
Office
Unavailable
Facility
$884.80
No comparable office rate is available.
Nevada**
Nevada · 45541
Office
Unavailable
Facility
$874.77
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 45541
Office
Unavailable
Facility
$1064.08
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 45541
Office
Unavailable
Facility
$962.50
No comparable office rate is available.
Queens
New York · 45541
Office
Unavailable
Facility
$1021.30
No comparable office rate is available.
Rest Of New York
New York · 45541
Office
Unavailable
Facility
$846.27
No comparable office rate is available.
Ohio
Ohio · 45541
Office
Unavailable
Facility
$864.68
No comparable office rate is available.
Oklahoma
Oklahoma · 45541
Office
Unavailable
Facility
$835.88
No comparable office rate is available.
Portland
Oregon · 45541
Office
Unavailable
Facility
$907.82
No comparable office rate is available.
Rest Of Oregon
Oregon · 45541
Office
Unavailable
Facility
$860.50
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 45541
Office
Unavailable
Facility
$931.08
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 45541
Office
Unavailable
Facility
$860.06
No comparable office rate is available.
Puerto Rico
Puerto Rico · 45541
Office
Unavailable
Facility
$892.74
No comparable office rate is available.
Rhode Island
Rhode Island · 45541
Office
Unavailable
Facility
$899.63
No comparable office rate is available.
South Carolina
South Carolina · 45541
Office
Unavailable
Facility
$852.62
No comparable office rate is available.
South Dakota**
South Dakota · 45541
Office
Unavailable
Facility
$825.82
No comparable office rate is available.
Tennessee
Tennessee · 45541
Office
Unavailable
Facility
$817.35
No comparable office rate is available.
Austin
Texas · 45541
Office
Unavailable
Facility
$898.55
No comparable office rate is available.
Beaumont
Texas · 45541
Office
Unavailable
Facility
$856.02
No comparable office rate is available.
Brazoria
Texas · 45541
Office
Unavailable
Facility
$870.36
No comparable office rate is available.
Dallas
Texas · 45541
Office
Unavailable
Facility
$880.02
No comparable office rate is available.
Fort Worth
Texas · 45541
Office
Unavailable
Facility
$878.20
No comparable office rate is available.
Galveston
Texas · 45541
Office
Unavailable
Facility
$875.67
No comparable office rate is available.
Houston
Texas · 45541
Office
Unavailable
Facility
$929.30
No comparable office rate is available.
Rest Of Texas
Texas · 45541
Office
Unavailable
Facility
$865.54
No comparable office rate is available.
Utah
Utah · 45541
Office
Unavailable
Facility
$862.26
No comparable office rate is available.
Virginia
Virginia · 45541
Office
Unavailable
Facility
$856.77
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 45541
Office
Unavailable
Facility
$892.74
No comparable office rate is available.
Vermont
Vermont · 45541
Office
Unavailable
Facility
$839.36
No comparable office rate is available.
Rest Of Washington
Washington · 45541
Office
Unavailable
Facility
$890.09
No comparable office rate is available.
Seattle (King Cnty)
Washington · 45541
Office
Unavailable
Facility
$967.28
No comparable office rate is available.
Wisconsin
Wisconsin · 45541
Office
Unavailable
Facility
$810.09
No comparable office rate is available.
West Virginia
West Virginia · 45541
Office
Unavailable
Facility
$892.46
No comparable office rate is available.
See how rates vary across the country
45541 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 45541 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$951.90
$865.36 × 110% = $951.90
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 45541 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,545
- Code
- 45541
- Physician work
- 14.48
- Practice expense
- 9.26
- Malpractice
- 2.93
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.48 | × 1.000 | 14.4800 |
| Practice expense | 9.26 | × 1.000 | 9.2600 |
| Malpractice | 2.93 | × 0.740 | 2.1682 |
| Total RVUs | 25.9082 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$865.36
Open 45541 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.48 | 1 |
| Practice expense | 9.26 | 1 |
| Malpractice | 2.93 | 0.74 |
(14.48 × 1 + 9.26 × 1 + 2.93 × 0.74) × $33.4009 = $865.36
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
45541 · 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 | $865.36 | RVU26D |
| 2026-07-01 | Not available in this setting | $865.36 | RVU26C |
| 2026-04-01 | Not available in this setting | $865.36 | RVU26B |
| 2026-01-01 | Not available in this setting | $865.36 | RVU26A |
| 2025-10-01 | Not available in this setting | $892.32 | RVU25D |
| 2025-07-01 | Not available in this setting | $892.32 | RVU25C |
| 2025-04-01 | Not available in this setting | $892.32 | RVU25B |
| 2025-01-01 | Not available in this setting | $892.32 | RVU25A |
45541 billing questions
How is 45541 distinguished from 45540?
45541 is for correction through a perineal route. Use 45540 for an abdominal approach to rectal prolapse.
Does a Delorme-type repair fit 45541?
Yes, a Delorme-type perineal repair is a representative procedure. The operative note should establish the perineal approach and the corrective work performed.
Is modifier 50 appropriate?
No. The anatomy and service descriptor make modifier 50 inappropriate for this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in the same session 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.
5,5424552F,,Pt ref for speech lang path,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
5,5434553F,,Pt asst re end life issues,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
5,54445540,,Correct rectal prolapse,A,,17.67,8.32,NA,8.32,,3.18,29.17,29.17,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,54545541,,Correct rectal prolapse,A,,14.48,9.26,NA,9.26,,2.93,26.67,26.67,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5464554F,,Pt recvd inhal anesthetic,M,,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
5,54745550,,Repair rectum/remove sigmoid,A,,24.18,11.73,NA,11.73,,4.58,40.49,40.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5484555F,,Pt recvd no inhal anesthic,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,