No office rate
Choose 45825 when rectourethral fistula repair is performed with a colostomy; 45820 represents the related repair without that colostomy circumstance.
On this page
CMS RVU26D · Effective 2026-10-01
45825 Fistula repair Medicare reimbursement rates in California
Surgical closure of a communication between the rectum and urethra performed with a colostomy to divert stool and protect the repair. Compare 45825 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 45825 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
$1422.45–$1656.31
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $233.86 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 45825 pays more and less in California
Colorectal surgery
About 45825: Rectourethral fistula repair with colostomy
Surgical closure of a communication between the rectum and urethra performed with a colostomy to divert stool and protect the repair.
This operation closes an abnormal passage between the rectum and urethra and creates a colostomy for fecal diversion. Colorectal or urologic surgeons may perform it for a fistula arising after pelvic surgery, radiation, trauma, or another disease process. The repair is typically undertaken in a hospital operating room, where the team can address the pelvic fistula and diversion during the same operative episode.
Report this code when the rectourethral fistula is surgically repaired with a colostomy; the operative report should identify the fistula site, repair performed, and diversion created. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45825
- 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 RVU23.57 · 54%
- Practice expense (office) RVU13.90 · 32%
- Malpractice RVU6.31 · 14%
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.
45825 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
45800 concerns a fistula between the rectum and bladder. This code is for a rectourethral fistula repaired with a colostomy.
No office rate
Both involve fistula repair with colostomy, but 45805 is associated with a different fistula site; identify the involved organs in the operative report.
Compare 45825 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 $1439.41 |
| Chico | Office Unavailable | Facility $1422.45 |
| El Centro | Office Unavailable | Facility $1423.51 |
| Fresno | Office Unavailable | Facility $1422.45 |
| Hanford-Corcoran | Office Unavailable | Facility $1422.45 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1508.72 |
| Madera | Office Unavailable | Facility $1422.45 |
| Merced | Office Unavailable | Facility $1422.45 |
| Modesto | Office Unavailable | Facility $1422.45 |
| Napa | Office Unavailable | Facility $1555.83 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1489.38 |
| Redding | Office Unavailable | Facility $1422.45 |
| Rest Of California | Office Unavailable | Facility $1422.45 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1490.05 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1468.52 |
| Salinas | Office Unavailable | Facility $1462.72 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1480.38 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1613.41 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1606.25 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1656.31 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1627.01 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1442.42 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1480.85 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1463.61 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1493.97 |
| Stockton | Office Unavailable | Facility $1422.45 |
| Vallejo | Office Unavailable | Facility $1545.51 |
| Visalia | Office Unavailable | Facility $1422.45 |
| Yuba City | Office Unavailable | Facility $1422.45 |
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45825 billing questions
How does this differ from 45820?
Both concern rectourethral fistula repair, but 45825 is the selection when the repair is performed with a colostomy. Use 45820 when the applicable repair is performed without that colostomy.
Is the colostomy part of the service?
The code identifies rectourethral fistula repair performed with a colostomy. Document the diversion and its relationship to the repair; do not infer separate reporting from the presence of a colostomy alone.
Does modifier 50 apply?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon be paid?
CMS permits assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are reduced to 50% when 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.
5,56045800,,Repair rect/bladder fistula,A,,19.80,11.12,NA,11.12,,5.29,36.21,36.21,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56145805,,Repair fistula w/colostomy,A,,22.74,12.89,NA,12.89,,6.08,41.71,41.71,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56245820,,Repair rectourethral fistula,A,,19.86,11.13,NA,11.13,,5.30,36.29,36.29,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56345825,,Repair fistula w/colostomy,A,,23.57,13.90,NA,13.90,,6.31,43.78,43.78,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56445900,,Reduction of rectal prolapse,A,,2.92,2.62,NA,2.62,,0.79,6.33,6.33,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56545905,,Dilation of anal sphincter,A,,2.29,2.35,NA,2.35,,0.42,5.06,5.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56645910,,Dilation of rectal narrowing,A,,2.78,2.37,NA,2.37,,0.48,5.63,5.63,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00