No office rate
Choose 45116 for the transsacral route. Code 45111 represents partial proctectomy through a different approach.
On this page
CMS RVU26D · Effective 2026-10-01
45116 Partial proctectomy Medicare reimbursement rates in California
Reports partial rectal removal through a transsacral approach with anastomosis when the surgeon documents this specific operative route and reconstruction. Compare 45116 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 45116 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
$1397.82–$1611.22
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $213.40 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 45116 pays more and less in California
Colorectal surgery
About 45116: Transsacral partial proctectomy with anastomosis
Reports partial rectal removal through a transsacral approach with anastomosis when the surgeon documents this specific operative route and reconstruction.
This service removes part of the rectum through a posterior route that accesses the rectum via the sacral or coccygeal area, then reconnects the remaining bowel. A colorectal or general surgeon may perform it for selected rectal conditions when this approach is chosen; the operative report should establish the extent of rectal resection and the route used. It is distinct from partial proctectomy performed through an abdominal, perineal, or transanal approach.
Select the code from the documented procedure and approach, not from the diagnosis alone. The operative report should describe the resection, transsacral access, and anastomosis. CMS assigns major-surgery status with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted for this code.
CMS billing rules for 45116
- 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 RVU27.03 · 64%
- Practice expense (office) RVU11.20 · 27%
- Malpractice RVU3.89 · 9%
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.
45116 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
Choose 45116 when the operative report documents transsacral access; 45112 is the perineal-approach sibling.
No office rate
Choose 45116 for a transsacral operation, not a transanal approach as represented by 45113.
No office rate
45116 represents partial rectal removal with anastomosis. Code 45110 is for complete rectal removal.
Compare 45116 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 $1409.11 |
| Chico | Office Unavailable | Facility $1397.82 |
| El Centro | Office Unavailable | Facility $1398.47 |
| Fresno | Office Unavailable | Facility $1397.82 |
| Hanford-Corcoran | Office Unavailable | Facility $1397.82 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1468.66 |
| Madera | Office Unavailable | Facility $1397.82 |
| Merced | Office Unavailable | Facility $1397.82 |
| Modesto | Office Unavailable | Facility $1397.82 |
| Napa | Office Unavailable | Facility $1518.76 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1451.23 |
| Redding | Office Unavailable | Facility $1397.82 |
| Rest Of California | Office Unavailable | Facility $1397.82 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1439.91 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1440.04 |
| Salinas | Office Unavailable | Facility $1434.03 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1447.74 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1575.70 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1571.28 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1611.22 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1593.16 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1413.91 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1445.95 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1433.94 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1458.94 |
| Stockton | Office Unavailable | Facility $1397.82 |
| Vallejo | Office Unavailable | Facility $1512.39 |
| Visalia | Office Unavailable | Facility $1397.82 |
| Yuba City | Office Unavailable | Facility $1397.82 |
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45116 billing questions
Is the anastomosis reported separately?
The anastomosis is part of the partial proctectomy service represented here; the code selection should reflect the documented resection and reconstruction.
What documentation supports this code?
The operative report should identify the partial rectal resection, the transsacral route, and the anastomosis. The diagnosis alone does not establish the approach.
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, and team surgery is not permitted for this code.
How are other same-session procedures handled?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to other procedures performed in the same session.
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.
5,46845112,,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
5,47245119,,Remove rectum w/reservoir,A,,32.64,13.77,NA,13.77,,4.71,51.12,51.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47345120,,Removal of rectum,A,,25.74,12.24,NA,12.24,,6.87,44.85,44.85,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47445121,,Removal of rectum and colon,A,,28.35,12.87,NA,12.87,,7.59,48.81,48.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00