No office rate
Both use a transanal approach, but 45172 represents full-thickness excision. Select based on the depth documented in the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
45171 Rectal tumor excision Medicare reimbursement rates in Idaho
Reports local removal of a rectal tumor through the anus when the excision is partial thickness rather than full thickness. Compare 45171 office and facility rates across CMS payment localities in Idaho.
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 45171 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$560.85
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
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.
Colorectal surgery
About 45171: Partial-thickness transanal rectal tumor excision
Reports local removal of a rectal tumor through the anus when the excision is partial thickness rather than full thickness.
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.
CMS billing rules for 45171
- 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 RVU7.93 · 43%
- Practice expense (office) RVU8.83 · 48%
- Malpractice RVU1.56 · 9%
2.5K
Medicare services in 2024 · #2296 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.
45171 compared with similar codes
Office rates for Idaho, from the same CMS release.
Compare 45171 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.
1 of 1 payment localities
Idaho →
Office / nonfacility
Unavailable
Facility
$560.85
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 45171 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
5,482
- Code
- 45171
- Physician work
- 7.93
- Practice expense
- 8.83
- Malpractice
- 1.56
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.93 | × 1.000 | 7.9300 |
| Practice expense | 8.83 | × 0.920 | 8.1236 |
| Malpractice | 1.56 | × 0.473 | 0.7379 |
| Total RVUs | 16.7915 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$560.85
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.93 | 1 |
| Practice expense | 8.83 | 0.92 |
| Malpractice | 1.56 | 0.473 |
(7.93 × 1 + 8.83 × 0.92 + 1.56 × 0.473) × $33.4009 = $560.85
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
5,47945136,,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
5,48345172,,Exc rect tum transanal full,A,,11.83,9.81,NA,9.81,,2.16,23.80,23.80,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48445190,,Destruction rectal tumor,A,,10.16,8.52,NA,8.52,,1.45,20.13,20.13,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4854525F,,Neuropsychia interven order,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772