Billing code 45540: Rectal prolapse repairMedicare rate & RVUs in Florida
Reported for an abdominal operation that repairs rectal prolapse without the sigmoid resection included in a separate code.
CMS doesn’t publish an office rate for 45540 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 45540 covers
A surgeon uses an abdominal approach to restore and support a prolapsing rectum, commonly by securing it within the pelvis as a rectopexy. The operation is performed for rectal prolapse and is typically done in a hospital operating room by a colorectal or general surgeon. The abdominal approach distinguishes this service from repair through the perineum and from laparoscopic rectopexy codes.
Select this code when the operative report documents an abdominal repair without sigmoid resection; use the separate resection code when sigmoid resection is part of the operation. The report should identify the prolapse, approach, repair performed, and any resection. The day-before preoperative visit and 90 days of related postoperative care are included. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the repair once; modifier 50 is not appropriate. Assistant-at-surgery payment may be available, co-surgeon payment requires supporting documentation, and team-surgery payment 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 45540 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 | $1,063.74 |
| Miami | Unavailable | $1,148.10 |
| Rest Of Florida | Unavailable | $1,015.50 |
How the 45540 rate is calculated
Each of 45540’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 · 45540
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.67Practice expense 8.32Malpractice 3.18
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45540
45540 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45540
Rectal prolapse repair
| 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 · 45540
Rectal prolapse repair
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
45540 without 51 · national facility
$974.30
Rectal prolapse repair
45540-51 · Second procedure: 50%
$487.15
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%).
45540 compared with similar codes
Compare codes
45540 vs 45541 vs 45550 vs 45400 vs 45402: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45541Prolapse repair
- Choose 45541 for a perineal repair; choose 45540 for an abdominal repair.
- 45550Rectal repair
- 45550 includes sigmoid resection with the abdominal prolapse repair. 45540 describes the repair without that resection.
- 45400Rectopexy
- 45400 describes laparoscopic rectopexy without resection. 45540 describes the abdominal approach represented by its code.
- 45402Laparoscopic rectopexy
- 45402 describes laparoscopic rectopexy with resection; 45540 is the abdominal repair code without sigmoid resection.
45540 billing questions
How is 45540 distinguished from 45550?
45540 describes abdominal repair without sigmoid resection. When the abdominal prolapse repair includes sigmoid resection, use 45550.
When should 45541 be reported instead?
45541 describes repair through a perineal approach. Use 45540 when the surgeon repairs the prolapse through an abdominal approach.
Does 45540 describe laparoscopic rectopexy?
No. Laparoscopic rectopexy is described by 45400 without resection or 45402 with resection; 45540 is for the abdominal approach represented by that code.
What operative documentation supports 45540?
Document the rectal prolapse, the abdominal approach, and the repair performed. State whether sigmoid resection was performed so the applicable repair code can be selected.
How does the global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the surgical global period.
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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