No office rate
Both codes address excision of rectal prolapse, but 45135 uses an abdominal approach and 45130 uses a perineal approach.
On this page
CMS RVU26D · Effective 2026-10-01
45135 Rectal prolapse excision Medicare reimbursement rates in Iowa
Reports abdominal surgery to excise rectal prolapse, distinguished from perineal excision and from procedures that suspend the rectum without excising it. Compare 45135 office and facility rates across CMS payment localities in Iowa.
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 45135 in Iowa?
Iowa 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
$1102.16
1 of 1 localities have a supported rate.
Payment area: Iowa
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 45135: Abdominal excision of rectal prolapse
Reports abdominal surgery to excise rectal prolapse, distinguished from perineal excision and from procedures that suspend the rectum without excising it.
This code describes an abdominal operation to remove tissue involved in rectal prolapse. A colorectal or general surgeon typically performs the procedure in a hospital operating room for a patient whose prolapse is being treated through an abdominal approach. The operative report should make the approach and excision clear, and describe the prolapse and any reconstruction performed. It is distinct from perineal excision, which uses a different operative route.
Choose this code when the documented operation excises the prolapsed rectum through an abdominal approach; do not select it solely because the surgeon treats prolapse. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45135
- 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 RVU21.80 · 61%
- Practice expense (office) RVU10.88 · 30%
- Malpractice RVU3.13 · 9%
21
Medicare services in 2024 · #5896 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.
45135 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
45540 describes abdominal rectopexy to treat prolapse. Use 45135 when the documented operation includes abdominal excision of prolapsed rectal tissue.
No office rate
45550 combines abdominal rectopexy with sigmoid resection. Distinguish it from 45135 by the documented procedure and whether rectopexy with sigmoid resection was performed.
Compare 45135 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1102.16
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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 45135 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,478
- Code
- 45135
- Physician work
- 21.80
- Practice expense
- 10.88
- Malpractice
- 3.13
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.80 | × 1.000 | 21.8000 |
| Practice expense | 10.88 | × 0.915 | 9.9552 |
| Malpractice | 3.13 | × 0.397 | 1.2426 |
| Total RVUs | 32.9978 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1102.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.8 | 1 |
| Practice expense | 10.88 | 0.915 |
| Malpractice | 3.13 | 0.397 |
(21.8 × 1 + 10.88 × 0.915 + 3.13 × 0.397) × $33.4009 = $1102.16
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.
45135 billing questions
How does this differ from 45130?
45135 is for excision of rectal prolapse through an abdominal approach. 45130 describes the perineal approach; follow the operative report rather than the diagnosis alone.
Is rectopexy alone reported with this code?
No. This code describes excision of prolapsed rectal tissue through an abdominal approach. A rectopexy without excision is a different procedure, such as 45540.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation.
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.
5,47545123,,Partial proctectomy,A,,18.39,9.25,NA,9.25,,3.28,30.92,30.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47645126,,Pelvic exenteration,A,,47.87,18.16,NA,18.16,,8.30,74.33,74.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47745130,,Excision of rectal prolapse,A,,18.04,8.80,NA,8.80,,3.24,30.08,30.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47845135,,Excision of rectal prolapse,A,,21.80,10.88,NA,10.88,,3.13,35.81,35.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47945136,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136