Billing code 45123: Partial proctectomyMedicare rate & RVUs in Guam
Reports surgical removal of part of the rectum when the operative service is a partial proctectomy rather than a limited lesion excision or complete proctectomy.
CMS doesn’t publish an office rate for 45123 in Guam.
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 45123 covers
A partial proctectomy removes a portion of the rectum as definitive surgery. Colorectal and general surgeons typically perform it in a hospital operating room for rectal disease that requires removal of rectal tissue, such as a malignancy or another condition requiring resection. The operative report should establish the extent of rectum removed and distinguish the resection from a biopsy or localized excision of a rectal lesion.
Select this code when the documented operation is a partial proctectomy; use a more specific neighboring code when the operative details meet that code’s definition. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate for this anatomy and descriptor. 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.
45123 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,028.96 |
How the 45123 rate is calculated
Each of 45123’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 · 45123
RVUs × geographic indexes × conversion factor
Work18.39
18.39 RVUs× 1.000 GPCI
Practice expense9.25
9.25 RVUs× 1.000 GPCI
Malpractice3.28
3.28 RVUs× 1.000 GPCI
Adjusted RVUs
30.9200
Conversion factor
$33.4009
Medicare rate
$1,032.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45123
45123 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45123
Partial proctectomy
| 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 · 45123
Partial proctectomy
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
45123 without 51 · national facility
$1,032.76
Partial proctectomy
45123-51 · Second procedure: 50%
$516.38
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%).
45123 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45111Partial proctectomy
- Both are partial-proctectomy codes. Choose based on the exact operative service documented and the distinctions in the current code set.
- 45113Partial proctectomy
- This is another partial-proctectomy option. Do not choose between the codes from the brief descriptor alone; match the operative details to the full billing code definition.
- 45110Rectal resection
- 45110 represents complete rectal removal, while 45123 is for partial removal.
- 45160Rectal lesion excision
- 45160 describes excision of a rectal lesion; 45123 is for a partial proctectomy, a broader rectal resection.
45123 billing questions
How do I distinguish this from a limited rectal lesion excision?
Use 45123 for a partial proctectomy, not a localized excision of a rectal lesion. The operative report should support removal of part of the rectum as a resection.
How does this differ from a complete proctectomy?
This code represents removal of part of the rectum. When the operation removes the rectum completely, select the applicable complete-proctectomy code instead.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this rectal resection; report the procedure without a bilateral adjustment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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