Billing code 45541: Prolapse repairMedicare rate & RVUs in Georgia
Reports operative correction of rectal prolapse through a perineal approach, such as a Delorme-type repair performed by a colorectal or general surgeon.
CMS doesn’t publish an office rate for 45541 in Georgia.
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 45541 covers
billing code 45541 describes surgical correction of rectal prolapse through the perineum rather than through an abdominal approach. A colorectal or general surgeon may perform a Delorme-type operation, which can involve removing a sleeve of rectal mucosa and plicating the underlying muscle. The service is generally performed in an operating room for a patient with prolapse extending through the anus; the operative report should identify the perineal route and the corrective work performed.
Report the code when the documented operation matches perineal repair, not abdominal rectopexy or a distinct prolapse excision procedure. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one 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 operation.
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 45541 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $916.87 |
| Rest Of Georgia | Unavailable | $876.19 |
How the 45541 rate is calculated
Each of 45541’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 · 45541
RVUs × geographic indexes × conversion factor
Work14.48
14.48 RVUs× 1.000 GPCI
Practice expense9.26
9.26 RVUs× 1.000 GPCI
Malpractice2.93
2.93 RVUs× 1.000 GPCI
Adjusted RVUs
26.6700
Conversion factor
$33.4009
Medicare rate
$890.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45541
45541 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45541
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 · 45541
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
45541 without 51 · national facility
$890.80
Prolapse repair
45541-51 · Second procedure: 50%
$445.40
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%).
45541 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45540Rectal prolapse repair
- Choose 45541 for a perineal repair; 45540 describes an abdominal approach.
- 45550Rectal repair
- 45550 describes abdominal prolapse repair with sigmoid resection. It is not the perineal repair represented by 45541.
- 45130Rectal prolapse repair
- 45130 represents perineal excision of rectal prolapse. Use 45541 when the documented service is repair rather than that excision procedure.
- 45400Rectopexy
- 45400 describes laparoscopic abdominal repair, while 45541 is for repair performed through a perineal approach.
45541 billing questions
How is 45541 distinguished from 45540?
45541 is for correction through a perineal route. Use 45540 for an abdominal approach to rectal prolapse.
Does a Delorme-type repair fit 45541?
Yes, a Delorme-type perineal repair is a representative procedure. The operative note should establish the perineal approach and the corrective work performed.
Is modifier 50 appropriate?
No. The anatomy and service descriptor make modifier 50 inappropriate for this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple-procedure reduction.
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
Fee sheets
Put 45541 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →