No office rate
Both describe complete rectal removal with colostomy, but 45112 includes pelvic lymph node dissection. Choose 45110 when that dissection is not performed.
On this page
CMS RVU26D · Effective 2026-10-01
45112 Rectal removal Medicare reimbursement rates in California
Reports complete rectal removal through an abdominal and perineal operation, with colostomy and pelvic lymph node dissection, commonly for rectal cancer. Compare 45112 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 45112 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1625.63–$1866.07
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $240.44 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 45112 pays more and less in California
Colorectal surgery
About 45112: Complete proctectomy with pelvic lymphadenectomy
Reports complete rectal removal through an abdominal and perineal operation, with colostomy and pelvic lymph node dissection, commonly for rectal cancer.
This operation removes the rectum through abdominal and perineal access, creates a colostomy, and includes pelvic lymph node dissection. Colorectal or general surgeons commonly perform it in a hospital for rectal cancer requiring this extent of resection. The operative report should establish the complete rectal resection, the colostomy, and the lymph node dissection; a limited rectal resection or a procedure using a different reconstruction belongs to a different code pathway.
CMS assigns 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 other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted. Modifier 50 is inappropriate for this operation.
CMS billing rules for 45112
- 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 RVU32.35 · 66%
- Practice expense (office) RVU12.11 · 25%
- Malpractice RVU4.66 · 9%
38
Medicare services in 2024 · #5528 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.
45112 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
45111 describes partial rectal removal with anastomosis. 45112 is for complete removal with colostomy and pelvic lymph node dissection.
No office rate
45119 uses an ileal reservoir reconstruction; 45112 includes colostomy creation and pelvic lymph node dissection.
No office rate
45121 includes removal of colon as well as rectum. 45112 describes complete rectal removal with colostomy and pelvic lymph node dissection.
Compare 45112 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1639.15 |
| Chico | Office Unavailable | Facility $1625.63 |
| El Centro | Office Unavailable | Facility $1626.41 |
| Fresno | Office Unavailable | Facility $1625.63 |
| Hanford-Corcoran | Office Unavailable | Facility $1625.63 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1706.68 |
| Madera | Office Unavailable | Facility $1625.63 |
| Merced | Office Unavailable | Facility $1625.63 |
| Modesto | Office Unavailable | Facility $1625.63 |
| Napa | Office Unavailable | Facility $1760.77 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1685.84 |
| Redding | Office Unavailable | Facility $1625.63 |
| Rest Of California | Office Unavailable | Facility $1625.63 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1676.05 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1673.26 |
| Salinas | Office Unavailable | Facility $1666.24 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1681.06 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1824.93 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1819.64 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1866.07 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1844.44 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1643.02 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1678.09 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1665.83 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1693.07 |
| Stockton | Office Unavailable | Facility $1625.63 |
| Vallejo | Office Unavailable | Facility $1753.15 |
| Visalia | Office Unavailable | Facility $1625.63 |
| Yuba City | Office Unavailable | Facility $1625.63 |
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45112 billing questions
How does 45112 differ from 45110?
45112 includes pelvic lymph node dissection with the complete rectal resection and colostomy. Use 45110 when that additional dissection is not performed.
Can 45112 be reported for a partial rectal resection?
No. This code represents complete rectal removal; partial resections with anastomosis are represented by other codes, such as 45111.
What operative documentation supports 45112?
The report should describe complete rectal removal, colostomy creation, and pelvic lymph node dissection, along with the abdominal and perineal operative work.
Can an assistant surgeon be paid for 45112?
CMS permits assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Should modifier 50 be used?
No. Modifier 50 is inappropriate for this operation.
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.
5,4654510F,,Prev cardrehab qualcardevent,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
5,46645110,,Removal of rectum,A,,29.99,14.55,NA,14.55,,5.53,50.07,50.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46745111,,Partial removal of rectum,A,,17.56,9.07,NA,9.07,,3.63,30.26,30.26,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46845112,,Removal of rectum,A,,32.35,12.11,NA,12.11,,4.66,49.12,49.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46945113,,Partial proctectomy,A,,32.39,13.71,NA,13.71,,4.66,50.76,50.76,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47045114,,Partial removal of rectum,A,,30.02,12.50,NA,12.50,,8.03,50.55,50.55,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47145116,,Partial removal of rectum,A,,27.03,11.20,NA,11.20,,3.89,42.12,42.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00