No office rate
This code represents a separate rectocele repair; 57250 describes posterior colporrhaphy by the vaginal approach. Use the code matching the documented operative technique.
On this page
CMS RVU26D · Effective 2026-10-01
45560 Rectocele repair Medicare reimbursement rates in California
Surgical repair of a rectocele is reported when the surgeon corrects weakened support between the rectum and vagina, rather than rectal prolapse. Compare 45560 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 45560 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
$628.95–$731.26
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $102.31 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 45560 pays more and less in California
Pelvic surgery
About 45560: Surgical rectocele repair
Surgical repair of a rectocele is reported when the surgeon corrects weakened support between the rectum and vagina, rather than rectal prolapse.
A rectocele occurs when the rectum bulges toward the posterior vaginal wall because the supporting tissue has weakened. This code describes a surgical repair directed at that defect. Gynecologic, urogynecologic, or colorectal surgeons may perform the operation for a patient with symptomatic pelvic organ prolapse in a surgical setting. The operative report should identify the rectocele and describe the repair performed; a diagnosis alone does not establish that this procedure was done.
Select this code for the rectocele repair documented, distinguishing it from vaginal posterior colporrhaphy and procedures for rectal prolapse. The 90-day global period includes 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 at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45560
- 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 RVU11.21 · 59%
- Practice expense (office) RVU5.84 · 31%
- Malpractice RVU1.92 · 10%
863
Medicare services in 2024 · #3078 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.
45560 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
57260 is for combined anterior and posterior vaginal wall repair. It is a different choice when both cystocele and rectocele defects are repaired.
$182.13–$235.12
45520 concerns treatment of rectal prolapse, not a rectocele. Choose based on whether the operative target is rectal prolapse or the rectovaginal support defect.
Compare 45560 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 $634.38 |
| Chico | Office Unavailable | Facility $628.95 |
| El Centro | Office Unavailable | Facility $629.27 |
| Fresno | Office Unavailable | Facility $628.95 |
| Hanford-Corcoran | Office Unavailable | Facility $628.95 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $663.12 |
| Madera | Office Unavailable | Facility $628.95 |
| Merced | Office Unavailable | Facility $628.95 |
| Modesto | Office Unavailable | Facility $628.95 |
| Napa | Office Unavailable | Facility $687.68 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $655.42 |
| Redding | Office Unavailable | Facility $628.95 |
| Rest Of California | Office Unavailable | Facility $628.95 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $649.65 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $649.13 |
| Salinas | Office Unavailable | Facility $646.48 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $653.71 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $714.47 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $712.29 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $731.26 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $722.35 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $637.34 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $653.66 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $646.72 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $659.57 |
| Stockton | Office Unavailable | Facility $628.95 |
| Vallejo | Office Unavailable | Facility $684.54 |
| Visalia | Office Unavailable | Facility $628.95 |
| Yuba City | Office Unavailable | Facility $628.95 |
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45560 billing questions
How does this differ from 57250?
Both relate to rectocele repair, but 57250 describes posterior colporrhaphy through a vaginal approach. Select the code that matches the operation documented.
Is modifier 50 appropriate for a bilateral repair?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
What documentation supports reporting this code?
The operative report should identify the rectocele and describe the surgical repair. The diagnosis by itself does not show that the repair was performed.
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.
5,5464554F,,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
5,54945560,,Repair of rectocele,A,,11.21,5.84,NA,5.84,,1.92,18.97,18.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,55045562,,Exploration/repair of rectum,A,,17.53,11.41,NA,11.41,,4.69,33.63,33.63,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,55145563,,Exploration/repair of rectum,A,,25.72,14.42,NA,14.42,,6.86,47.00,47.00,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5524556F,,Pt w/3+ post-op nausea&vom,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