No office rate
45119 describes surgery that creates an ileoanal reservoir during proctectomy. Use 45136 when the operation removes an already constructed reservoir.
On this page
CMS RVU26D · Effective 2026-10-01
45136 Ileoanal pouch excision Medicare reimbursement rates in Florida
Removal of a previously constructed ileoanal pouch is reported when the reservoir is excised during operative management of pouch failure or disease. Compare 45136 office and facility rates across CMS payment localities in Florida.
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 45136 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1686.13–$1875.56
3 of 3 localities have a supported rate.
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 45136 pays more and less in Florida
Colorectal surgery
About 45136: Excision of ileoanal pouch
Removal of a previously constructed ileoanal pouch is reported when the reservoir is excised during operative management of pouch failure or disease.
Code 45136 identifies operative removal of an ileoanal reservoir, or pouch, previously fashioned from ileum and connected to the anal canal, rather than construction of a new pouch. Colorectal surgeons may perform the operation for a failed or diseased pouch, including persistent inflammatory or septic complications or unacceptable pouch function. It is performed in an operating room, generally in a hospital or other surgical facility. The operative report should establish that an existing ileoanal reservoir was excised and describe the indication and extent of the work; rectal excision alone is not enough to support this code.
Report the service for the pouch excision documented, distinguishing it from initial pouch-forming surgery and other rectal resections. This major operation has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.
CMS billing rules for 45136
- 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 RVU30.05 · 61%
- Practice expense (office) RVU14.58 · 30%
- Malpractice RVU4.32 · 9%
78
Medicare services in 2024 · #5076 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.
45136 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
45110 represents complete rectal removal. Choose 45136 when the operative service is excision of an existing ileoanal pouch, rather than a complete proctectomy.
No office rate
45111 represents partial proctectomy. It is not the pouch-excision code when the operative report documents removal of a previously constructed ileoanal reservoir.
Compare 45136 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$1757.89
Miami →
Office / nonfacility
Unavailable
Facility
$1875.56
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$1686.13
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45136 billing questions
How is pouch excision different from pouch construction?
Report 45136 for excision of an existing ileoanal reservoir. Code 45119 is the related option for an operation that constructs an ileoanal reservoir.
What documentation supports 45136?
The operative report should identify the previously created ileoanal reservoir, confirm its excision, and describe the indication and extent of the operation.
Does the 90-day global include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code because of the descriptor or anatomy.
How are multiple procedures handled in the same session?
The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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.
5,47645126,,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
5,47945136,,Excise ileoanal reservior,A,,30.05,14.58,NA,14.58,,4.32,48.95,48.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48045150,,Excision of rectal stricture,A,,5.70,5.31,NA,5.31,,1.51,12.52,12.52,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48145160,,Excision of rectal lesion,A,,15.92,9.06,NA,9.06,,4.25,29.23,29.23,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48245171,,Exc rect tum transanal part,A,,7.93,8.83,NA,8.83,,1.56,18.32,18.32,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00