No office rate
Use 45119 when complete rectal removal includes a colonic reservoir and low pelvic anastomosis. Code 45110 describes complete removal with a colostomy.
On this page
CMS RVU26D · Effective 2026-10-01
45119 Proctectomy Medicare reimbursement rates in Kansas
Report this operation for complete rectal removal with reconstruction using a colonic reservoir and a low pelvic anastomosis. Compare 45119 office and facility rates across CMS payment localities in Kansas.
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 45119 in Kansas?
Kansas 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
$1585.27
1 of 1 localities have a supported rate.
Payment area: Kansas
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 45119: Complete proctectomy with colonic reservoir
Report this operation for complete rectal removal with reconstruction using a colonic reservoir and a low pelvic anastomosis.
This operation removes the rectum and forms a reservoir from the remaining colon for a low pelvic anastomosis. Colorectal surgeons typically perform it in a hospital operating room when the planned reconstruction preserves the route for stool passage rather than ending in a permanent colostomy. A very low rectal resection, including for rectal cancer, is a common clinical setting for this type of reconstruction.
Select the code when the operative report supports complete rectal removal and construction of the colonic reservoir; a partial resection or a different reconstruction calls for another code. Document the extent of removal, reservoir creation, and anastomosis. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this operation. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45119
- 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 RVU32.64 · 64%
- Practice expense (office) RVU13.77 · 27%
- Malpractice RVU4.71 · 9%
21
Medicare services in 2024 · #5895 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.
45119 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
45111 is for partial proctectomy with anastomosis. This code requires complete rectal removal and construction of a colonic reservoir.
No office rate
45120 describes complete proctectomy by an abdominal approach without the reservoir reconstruction that distinguishes 45119.
No office rate
45121 is a proctocolectomy with ileostomy, removing the colon as well as the rectum. This code describes rectal removal with a colonic reservoir.
Compare 45119 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1585.27
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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 45119 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,472
- Code
- 45119
- Physician work
- 32.64
- Practice expense
- 13.77
- Malpractice
- 4.71
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 32.64 | × 1.000 | 32.6400 |
| Practice expense | 13.77 | × 0.904 | 12.4481 |
| Malpractice | 4.71 | × 0.504 | 2.3738 |
| Total RVUs | 47.4619 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1585.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 32.64 | 1 |
| Practice expense | 13.77 | 0.904 |
| Malpractice | 4.71 | 0.504 |
(32.64 × 1 + 13.77 × 0.904 + 4.71 × 0.504) × $33.4009 = $1585.27
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.
45119 billing questions
How does this differ from a complete proctectomy with colostomy?
This code describes complete rectal removal with a colonic reservoir and low pelvic anastomosis. A complete proctectomy ending in a colostomy is represented by a different code.
Can this code be used for partial rectal removal?
No. The operative documentation must support complete rectal removal and creation of the colonic reservoir; partial proctectomy codes describe a different extent of resection.
Is modifier 50 appropriate?
No. CMS identifies bilateral adjustment as inappropriate for this operation.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
5,46945113,,Partial proctectomy,A,,32.39,13.71,NA,13.71,,4.66,50.76,50.76,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47045114,,Partial removal of rectum,A,,30.02,12.50,NA,12.50,,8.03,50.55,50.55,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47145116,,Partial removal of rectum,A,,27.03,11.20,NA,11.20,,3.89,42.12,42.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47245119,,Remove rectum w/reservoir,A,,32.64,13.77,NA,13.77,,4.71,51.12,51.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47345120,,Removal of rectum,A,,25.74,12.24,NA,12.24,,6.87,44.85,44.85,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47445121,,Removal of rectum and colon,A,,28.35,12.87,NA,12.87,,7.59,48.81,48.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47545123,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958