No office rate
This code is for diagnostic rectal tissue sampling. Anorectal myomectomy removes muscle as a therapeutic procedure.
On this page
CMS RVU26D · Effective 2026-10-01
45108 Anorectal myomectomy Medicare reimbursement rates in Massachusetts
Surgical removal of a segment of anorectal muscle, reported for selected outlet-obstruction conditions such as Hirschsprung disease. Compare 45108 office and facility rates across CMS payment localities in Massachusetts.
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 45108 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$374.97–$406.06
2 of 2 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.
Colorectal surgery
About 45108: Anorectal muscle myomectomy
Surgical removal of a segment of anorectal muscle, reported for selected outlet-obstruction conditions such as Hirschsprung disease.
Anorectal myomectomy removes a portion of muscle in the anorectal wall. A colorectal or pediatric surgeon may perform it for selected patients with impaired outlet relaxation, including patients with Hirschsprung disease. This is a specialized muscle procedure, not a diagnostic rectal biopsy or removal of a rectal tumor, and it is generally performed in an operating room.
Report the procedure when the operative documentation supports removal of anorectal muscle for the patient’s condition; the report should identify the site, extent, and indication. Medicare treats it as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is barred by statutory restriction; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45108
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.99 · 45%
- Practice expense (office) RVU4.84 · 43%
- Malpractice RVU1.33 · 12%
15
Medicare services in 2024 · #6074 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.
45108 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
45160
No office rateRectal lesion excision
This code describes excision of a rectal lesion. Use anorectal myomectomy when the operation removes anorectal muscle rather than a lesion.
No office rate
This code describes partial-thickness transanal excision of a rectal tumor; it is not a muscle myomectomy.
No office rate
This code describes full-thickness transanal excision of a rectal tumor. Anorectal myomectomy is selected for removal of anorectal muscle, not tumor excision.
Compare 45108 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$406.06
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$374.97
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45108 billing questions
How is this different from a rectal biopsy?
A biopsy obtains tissue for diagnosis. Anorectal myomectomy removes a portion of anorectal muscle as a therapeutic operation.
Can a rectal tumor excision be reported instead?
No. Tumor excision codes describe removal of a rectal lesion; this code describes removal of anorectal muscle for a different clinical purpose.
Does the procedure have a 90-day global period?
Yes. The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures subject to the standard multiple-procedure rule are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is barred by statutory restriction. 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.
5,4614500F,,Ref to outpt card rehab prog,M,,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
5,46245020,,Drainage of rectal abscess,A,,8.35,6.54,NA,6.54,,1.63,16.52,16.52,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46345100,,Biopsy of rectum,A,,3.94,4.33,NA,4.33,,0.78,9.05,9.05,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46445108,,Anorectal myomectomy,A,,4.99,4.84,NA,4.84,,1.33,11.16,11.16,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4654510F,,Prev cardrehab qualcardevent,M,,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
5,46645110,,Removal of rectum,A,,29.99,14.55,NA,14.55,,5.53,50.07,50.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,46745111,,Partial removal of rectum,A,,17.56,9.07,NA,9.07,,3.63,30.26,30.26,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00