45395 Rectal resection Medicare reimbursement rates in Massachusetts

This code describes a complete laparoscopic proctectomy performed through combined abdominal and perineal approaches, with a colostomy. It is commonly used for operations such as abdominoperineal resection for low rectal cancer when the rectum and anus are removed and an end colostomy is created. A colorectal surgeon typically performs the operation in a hospital operating room; the procedure may also be used for other conditions requiring this extent of resection.

Choose the code when the operative report supports the laparoscopic approach, complete rectal removal, the combined abdominoperineal operation, and colostomy creation. The report should make the extent and approach clear. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.