CPT code 45120: Rectal resection2026 Medicare rate & RVUs in Illinois
Reports complete rectal removal through an abdominal approach with colostomy, such as for rectal disease requiring resection rather than a partial proctectomy.
CMS doesn’t publish an office rate for 45120 in Illinois.
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 45120 covers
This operation removes the rectum completely through an abdominal approach and includes creation of a colostomy. Colorectal surgeons typically perform it in a hospital operating room for conditions such as rectal cancer when the planned operation requires complete rectal removal and a colostomy. The operative report should establish the extent of rectal resection, the abdominal approach, and the colostomy created as part of the procedure.
Choose this code when the documented operation matches those elements, rather than a partial rectal resection, a combined abdominal-perineal operation, or a reconstruction using a reservoir. The colostomy is included in the reported service. Medicare assigns a 90-day global period, including 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 multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Modifier 50 is inappropriate, 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 45120 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,803.25 |
| East St. Louis | Unavailable | $1,698.00 |
| Rest Of Illinois | Unavailable | $1,591.65 |
| Suburban Chicago | Unavailable | $1,692.23 |
How the 45120 rate is calculated
Each of 45120’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 · 45120
RVUs × geographic indexes × conversion factor
Work25.74
25.74 RVUs× 1.000 GPCI
Practice expense12.24
12.24 RVUs× 1.000 GPCI
Malpractice6.87
6.87 RVUs× 1.000 GPCI
Adjusted RVUs
44.8500
Conversion factor
$33.4009
Medicare rate
$1,498.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45120
45120 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45120
Rectal resection
| 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 · 45120
Rectal resection
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
45120 without 51 · national facility
$1,498.03
Rectal resection
45120-51 · Second procedure: 50%
$749.02
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%).
45120 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45110Rectal resection
- Both describe complete rectal removal with colostomy, but 45110 specifies a combined abdominal-perineal approach; this code specifies an abdominal approach.
- 45111Partial proctectomy
- 45111 applies to partial proctectomy with anastomosis. This code is for complete rectal removal with colostomy.
- 45121Proctocolectomy
- 45121 includes removal of the colon as well as the rectum. Use this code when the documented resection is limited to complete rectal removal with colostomy.
45120 billing questions
How does this differ from code 45110?
This code describes a complete proctectomy through an abdominal approach with colostomy. Code 45110 describes a combined abdominal-perineal operation with colostomy.
Is colostomy creation included?
Yes. Colostomy creation is part of the service described by this code and should be reflected in the operative documentation.
When should a partial proctectomy code be considered instead?
Use a partial proctectomy code when the operative report documents removal of only part of the rectum, rather than complete rectal removal.
Can an assistant surgeon be reported?
Medicare may pay for an assistant at surgery for this procedure. Co-surgeon payment requires supporting documentation.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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