No office rate
Both describe complete rectal removal with colostomy, but 45110 specifies a combined abdominal-perineal approach; this code specifies an abdominal approach.
On this page
CMS RVU26D · Effective 2026-10-01
45120 Rectal resection Medicare reimbursement rates in Missouri
Reports complete rectal removal through an abdominal approach with colostomy, such as for rectal disease requiring resection rather than a partial proctectomy. Compare 45120 office and facility rates across CMS payment localities in Missouri.
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 45120 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1435.65–$1478.87
3 of 3 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.
Where 45120 pays more and less in Missouri
Colorectal surgery
About 45120: Complete abdominal proctectomy with colostomy
Reports complete rectal removal through an abdominal approach with colostomy, such as for rectal disease requiring resection rather than a partial proctectomy.
This operation removes the rectum completely through an abdominal approach and includes creation of a colostomy. Colorectal surgeons typically perform it in a hospital operating room for conditions such as rectal cancer when the planned operation requires complete rectal removal and a colostomy. The operative report should establish the extent of rectal resection, the abdominal approach, and the colostomy created as part of the procedure.
Choose this code when the documented operation matches those elements, rather than a partial rectal resection, a combined abdominal-perineal operation, or a reconstruction using a reservoir. The colostomy is included in the reported service. Medicare 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 multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. Modifier 50 is inappropriate, and team surgery is not permitted.
CMS billing rules for 45120
- 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 RVU25.74 · 57%
- Practice expense (office) RVU12.24 · 27%
- Malpractice RVU6.87 · 15%
24
Medicare services in 2024 · #5816 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.
45120 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
45111 applies to partial proctectomy with anastomosis. This code is for complete rectal removal with colostomy.
No office rate
45121 includes removal of the colon as well as the rectum. Use this code when the documented resection is limited to complete rectal removal with colostomy.
Compare 45120 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$1467.81
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1478.87
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$1435.65
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45120 billing questions
How does this differ from code 45110?
This code describes a complete proctectomy through an abdominal approach with colostomy. Code 45110 describes a combined abdominal-perineal operation with colostomy.
Is colostomy creation included?
Yes. Colostomy creation is part of the service described by this code and should be reflected in the operative documentation.
When should a partial proctectomy code be considered instead?
Use a partial proctectomy code when the operative report documents removal of only part of the rectum, rather than complete rectal removal.
Can an assistant surgeon be reported?
Medicare may pay for an assistant at surgery for this procedure. Co-surgeon payment requires supporting documentation.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,47045114,,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
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