Billing code 45171: Rectal tumor excisionMedicare rate & RVUs in Florida
Reports local removal of a rectal tumor through the anus when the excision is partial thickness rather than full thickness.
CMS doesn’t publish an office rate for 45171 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 45171 covers
A colorectal surgeon removes a rectal tumor through the anal canal, excising part of the rectal wall rather than taking the entire wall thickness. This approach may be selected for a lesion suitable for local removal, such as an adenoma or an early rectal tumor. The service is generally performed in an operating room, with the operative report identifying the lesion, transanal route, and depth of excision.
Report this code when the documented work is a partial-thickness transanal excision; a full-thickness excision belongs to the related code for that extent. A diagnostic biopsy alone is not the same service. The 90-day global period includes 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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 45171 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 | $657.84 |
| Miami | Unavailable | $703.67 |
| Rest Of Florida | Unavailable | $625.14 |
How the 45171 rate is calculated
Each of 45171’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 · 45171
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.93Practice expense 8.83Malpractice 1.56
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45171
45171 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45171
Rectal tumor excision
| 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 · 45171
Rectal tumor excision
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
45171 without 51 · national facility
$611.90
Rectal tumor excision
45171-51 · Second procedure: 50%
$305.95
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%).
45171 compared with similar codes
Compare codes
45171 vs 45172 vs 45100 vs 45160: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45172Rectal tumor excision
- Both use a transanal approach, but 45172 represents full-thickness excision. Select based on the depth documented in the operative report.
- 45100Rectal biopsy
- 45100 is for rectal biopsy and tissue sampling; this code is for partial-thickness removal of a rectal tumor.
- 45160Rectal lesion excision
- 45160 uses a transsacral or transcoccygeal route. This code is for removal through the anus.
45171 billing questions
How is this code distinguished from 45172?
This code describes partial-thickness removal through the anus. Use 45172 when the operative report documents a full-thickness excision.
Can a diagnostic rectal biopsy be reported as this service?
No. A biopsy for tissue diagnosis is a different service; this code is for excision of the tumor with partial-thickness removal of the rectal wall.
What operative documentation supports this code?
Document the rectal lesion, the transanal approach, and that the excision was partial thickness. The operative note should distinguish the work from a biopsy or full-thickness excision.
Does modifier 50 apply?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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 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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