No office rate
Both are partial-proctectomy codes. Choose based on the exact operative service documented and the distinctions in the current CPT code set.
On this page
CMS RVU26D · Effective 2026-10-01
45123 Partial proctectomy Medicare reimbursement rates in Colorado
Reports surgical removal of part of the rectum when the operative service is a partial proctectomy rather than a limited lesion excision or complete proctectomy. Compare 45123 office and facility rates across CMS payment localities in Colorado.
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 45123 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1035.91
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Colorectal surgery
About 45123: Partial rectal resection
Reports surgical removal of part of the rectum when the operative service is a partial proctectomy rather than a limited lesion excision or complete proctectomy.
A partial proctectomy removes a portion of the rectum as definitive surgery. Colorectal and general surgeons typically perform it in a hospital operating room for rectal disease that requires removal of rectal tissue, such as a malignancy or another condition requiring resection. The operative report should establish the extent of rectum removed and distinguish the resection from a biopsy or localized excision of a rectal lesion.
Select this code when the documented operation is a partial proctectomy; use a more specific neighboring code when the operative details meet that code’s definition. 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy and descriptor. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45123
- 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 RVU18.39 · 59%
- Practice expense (office) RVU9.25 · 30%
- Malpractice RVU3.28 · 11%
121
Medicare services in 2024 · #4734 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.
45123 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
This is another partial-proctectomy option. Do not choose between the codes from the brief descriptor alone; match the operative details to the full CPT definition.
No office rate
45110 represents complete rectal removal, while 45123 is for partial removal.
45160
No office rateRectal lesion excision
45160 describes excision of a rectal lesion; 45123 is for a partial proctectomy, a broader rectal resection.
Compare 45123 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$1035.91
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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 45123 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
5,475
- Code
- 45123
- Physician work
- 18.39
- Practice expense
- 9.25
- Malpractice
- 3.28
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.39 | × 1.012 | 18.6107 |
| Practice expense | 9.25 | × 1.064 | 9.8420 |
| Malpractice | 3.28 | × 0.781 | 2.5617 |
| Total RVUs | 31.0144 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$1035.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.39 | 1.012 |
| Practice expense | 9.25 | 1.064 |
| Malpractice | 3.28 | 0.781 |
(18.39 × 1.012 + 9.25 × 1.064 + 3.28 × 0.781) × $33.4009 = $1035.91
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.
45123 billing questions
How do I distinguish this from a limited rectal lesion excision?
Use 45123 for a partial proctectomy, not a localized excision of a rectal lesion. The operative report should support removal of part of the rectum as a resection.
How does this differ from a complete proctectomy?
This code represents removal of part of the rectum. When the operation removes the rectum completely, select the applicable complete-proctectomy code instead.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this rectal resection; report the procedure without a bilateral adjustment.
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 or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
5,47245119,,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
5,47545123,,Partial proctectomy,A,,18.39,9.25,NA,9.25,,3.28,30.92,30.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47645126,,Pelvic exenteration,A,,47.87,18.16,NA,18.16,,8.30,74.33,74.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47745130,,Excision of rectal prolapse,A,,18.04,8.80,NA,8.80,,3.24,30.08,30.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47845135,,Excision of rectal prolapse,A,,21.80,10.88,NA,10.88,,3.13,35.81,35.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899