Billing code 45114: Rectal resectionMedicare rate & RVUs in Florida
Reports removal of part of the rectum with anastomosis and colostomy, typically during operative treatment of rectal disease.
CMS doesn’t publish an office rate for 45114 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 45114 covers
A colorectal or general surgeon removes a portion of the rectum, reconnects the bowel, and creates a colostomy during the same operation. This is major operative treatment for rectal disease, including cases requiring segmental resection; the operative report should establish the rectal resection, the anastomosis, and the colostomy performed.
Select this code when all three elements are documented, rather than choosing it solely from the diagnosis or the fact that a stoma was created. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this rectal procedure.
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.
Where 45114 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,910.56 |
| Miami | Unavailable | $2,115.63 |
| Rest Of Florida | Unavailable | $1,804.95 |
How the 45114 rate is calculated
Each of 45114’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 45114
RVUs × geographic indexes × conversion factor
Work30.02
30.02 RVUs× 1.000 GPCI
Practice expense12.50
12.50 RVUs× 1.000 GPCI
Malpractice8.03
8.03 RVUs× 1.000 GPCI
Adjusted RVUs
50.5500
Conversion factor
$33.4009
Medicare rate
$1,688.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45114
45114 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45114
Rectal resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 45114
Rectal resection
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45114 without 51 · national facility
$1,688.42
Rectal resection
45114-51 · Second procedure: 50%
$844.21
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
45114 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45112Rectal removal
- Use 45112 for partial proctectomy with anastomosis when a colostomy is not performed. This code includes both the anastomosis and colostomy.
- 45113Partial proctectomy
- 45113 describes partial proctectomy with colostomy without the anastomosis represented by this code.
- 45119Proctectomy
- 45119 is for partial proctectomy with colonic J-pouch reconstruction; this code describes anastomosis with colostomy instead.
- 45110Rectal resection
- 45110 represents complete proctectomy, while this code is for removal of only part of the rectum with anastomosis and colostomy.
45114 billing questions
How does this differ from 45112?
This code includes a colostomy along with partial rectal resection and anastomosis. Choose 45112 when the documented procedure includes the anastomosis but not a colostomy.
Does the code include the colostomy?
Yes. The colostomy is part of the procedure represented by this code when performed with the partial proctectomy and anastomosis.
What operative documentation supports reporting it?
The operative report should identify the portion of rectum removed and document both the bowel anastomosis and creation of a colostomy.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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.
Should modifier 50 be used?
No. Modifier 50 is inappropriate for this rectal resection.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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