No office rate
45905 addresses dilation of the anal sphincter; 45910 is for dilation of a rectal stricture. Choose based on the treated anatomy.
On this page
CMS RVU26D · Effective 2026-10-01
45910 Rectal dilation Medicare reimbursement rates in Illinois
Dilation of a documented rectal stricture under anesthesia other than local, reported when the narrowed rectal segment is mechanically or balloon-expanded. Compare 45910 office and facility rates across CMS payment localities in Illinois.
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 45910 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$190.19–$209.85
4 of 4 localities have a supported rate.
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.
Where 45910 pays more and less in Illinois
Anorectal surgery
About 45910: Rectal stricture dilation under anesthesia
Dilation of a documented rectal stricture under anesthesia other than local, reported when the narrowed rectal segment is mechanically or balloon-expanded.
This service treats a narrowed rectal segment by expanding the stricture, for example with a balloon or other dilation instrument. A colorectal or general surgeon typically performs the procedure in an operating or procedure room with anesthesia beyond local anesthesia. The clinical problem is a rectal narrowing requiring dilation, not simply a tight anal sphincter or a rectal obstruction that is removed.
Report the code when the operative note identifies the rectal stricture and documents its dilation and the anesthesia used. The 10-day global period includes related postoperative visits during that period. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 45910
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.78 · 49%
- Practice expense (office) RVU2.37 · 42%
- Malpractice RVU0.48 · 9%
235
Medicare services in 2024 · #4185 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.
45910 compared with similar codes
Office rates for Illinois, from the same CMS release.
$470.46–$524.47
45340 describes stricture dilation performed with flexible sigmoidoscopy. Use 45910 for the rectal dilation service under anesthesia when the endoscopic service is not the appropriate description.
$390.88–$432.42
45915 describes removal of a rectal obstruction. It is not the code for expanding a narrowed rectal segment.
Compare 45910 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$209.85
East St. Louis →
Office / nonfacility
Unavailable
Facility
$197.97
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$190.19
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$203.21
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45910 billing questions
How is rectal stricture dilation different from anal sphincter dilation?
Code 45910 is for a narrowing in the rectum. Code 45905 describes dilation directed at the anal sphincter, so the documented site determines the choice.
What documentation supports reporting 45910?
Document the rectal stricture, its location when known, the dilation performed, and anesthesia other than local. The note should distinguish the rectal narrowing from an anal sphincter problem.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure's payment.
Can modifier 50 be used?
No. The anatomy or descriptor makes a bilateral adjustment and modifier 50 inappropriate for this service.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction. An assistant at surgery is not paid; co-surgeons and team surgery are 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.
5,56345825,,Repair fistula w/colostomy,A,,23.57,13.90,NA,13.90,,6.31,43.78,43.78,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56445900,,Reduction of rectal prolapse,A,,2.92,2.62,NA,2.62,,0.79,6.33,6.33,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56545905,,Dilation of anal sphincter,A,,2.29,2.35,NA,2.35,,0.42,5.06,5.06,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56645910,,Dilation of rectal narrowing,A,,2.78,2.37,NA,2.37,,0.48,5.63,5.63,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56745915,,Remove rectal obstruction,A,,3.11,8.35,,3.21,,0.62,12.08,6.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56845990,,Surg dx exam anorectal,A,,1.76,0.87,NA,0.87,,0.35,2.98,2.98,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,56945999,,Unlisted procedure rectum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00