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CMS RVU26D · Effective 2026-10-01

45112 Rectal removal Medicare reimbursement rates in Minnesota

Reports complete rectal removal through an abdominal and perineal operation, with colostomy and pelvic lymph node dissection, commonly for rectal cancer. Compare 45112 office and facility rates across CMS payment localities in Minnesota.

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 45112 in Minnesota?

Minnesota 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

$1542.81

1 of 1 localities have a supported rate.

Payment area: Minnesota

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.

Find 45112 in your payment locality →

Colorectal surgery

About 45112: Complete proctectomy with pelvic lymphadenectomy

Reports complete rectal removal through an abdominal and perineal operation, with colostomy and pelvic lymph node dissection, commonly for rectal cancer.

This operation removes the rectum through abdominal and perineal access, creates a colostomy, and includes pelvic lymph node dissection. Colorectal or general surgeons commonly perform it in a hospital for rectal cancer requiring this extent of resection. The operative report should establish the complete rectal resection, the colostomy, and the lymph node dissection; a limited rectal resection or a procedure using a different reconstruction belongs to a different code pathway.

CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted. Modifier 50 is inappropriate for this operation.

CMS billing rules for 45112

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 RVU32.35 · 66%
  • Practice expense (office) RVU12.11 · 25%
  • Malpractice RVU4.66 · 9%

38

Medicare services in 2024 · #5528 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.

45112 compared with similar codes

Office rates for Minnesota, from the same CMS release.

45110

Rectal resection

Abdominal and perineal approach

No office rate

Both describe complete rectal removal with colostomy, but 45112 includes pelvic lymph node dissection. Choose 45110 when that dissection is not performed.

45111

Partial proctectomy

Abdominal approach, anastomosis

No office rate

45111 describes partial rectal removal with anastomosis. 45112 is for complete removal with colostomy and pelvic lymph node dissection.

45119

Proctectomy

Colonic reservoir reconstruction

No office rate

45119 uses an ileal reservoir reconstruction; 45112 includes colostomy creation and pelvic lymph node dissection.

45121

Proctocolectomy

Colon and rectum removed

No office rate

45121 includes removal of colon as well as rectum. 45112 describes complete rectal removal with colostomy and pelvic lymph node dissection.

Compare 45112 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

Office and facility base rates · shared scale starting at $0

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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 45112 in Minnesota.

PPRRVU2026_Oct_nonQPP.csv

5,468

Code
45112
Physician work
32.35
Practice expense
12.11
Malpractice
4.66

GPCI2026.csv

66

Locality
Minnesota
Physician work
1.000
Practice expense
1.029
Malpractice
0.296
Facility calculation for 45112 in Minnesota
ComponentRVULocality factorAdjusted
Physician work32.35× 1.00032.3500
Practice expense12.11× 1.02912.4612
Malpractice4.66× 0.2961.3794
Total RVUs46.1905
Conversion factor× 33.4009

Facility rate, Minnesota$1542.81

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work32.351
Practice expense12.111.029
Malpractice4.660.296

(32.35 × 1 + 12.11 × 1.029 + 4.66 × 0.296) × $33.4009 = $1542.81

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.

45112 billing questions

How does 45112 differ from 45110?

45112 includes pelvic lymph node dissection with the complete rectal resection and colostomy. Use 45110 when that additional dissection is not performed.

Can 45112 be reported for a partial rectal resection?

No. This code represents complete rectal removal; partial resections with anastomosis are represented by other codes, such as 45111.

What operative documentation supports 45112?

The report should describe complete rectal removal, colostomy creation, and pelvic lymph node dissection, along with the abdominal and perineal operative work.

Can an assistant surgeon be paid for 45112?

CMS permits assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Should modifier 50 be used?

No. Modifier 50 is inappropriate for this operation.

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.

RVUs for 45112PPRRVU2026_Oct_nonQPP.csv, line 5,468 (RVU26D)
Geographic factors for MinnesotaGPCI2026.csv, line 66 (RVU26D)