No office rate
Choose 45395 when the laparoscopic complete proctectomy includes colostomy creation. Choose 45397 for the related pouch reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
45395 Rectal resection Medicare reimbursement rates in Nebraska
Reports laparoscopic removal of the rectum through abdominal and perineal approaches when the operation includes creation of a colostomy. Compare 45395 office and facility rates across CMS payment localities in Nebraska.
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 45395 in Nebraska?
Nebraska 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
$1634.30
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 45395: Laparoscopic complete proctectomy with colostomy
Reports laparoscopic removal of the rectum through abdominal and perineal approaches when the operation includes creation of a colostomy.
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.
CMS billing rules for 45395
- 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 RVU32.18 · 60%
- Practice expense (office) RVU15.69 · 29%
- Malpractice RVU6.00 · 11%
1K
Medicare services in 2024 · #2949 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.
45395 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Both describe complete abdominoperineal proctectomy with colostomy; 45395 is laparoscopic, while 45110 is the open procedure.
Compare 45395 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$1634.30
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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 45395 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
5,528
- Code
- 45395
- Physician work
- 32.18
- Practice expense
- 15.69
- Malpractice
- 6.00
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 32.18 | × 1.000 | 32.1800 |
| Practice expense | 15.69 | × 0.923 | 14.4819 |
| Malpractice | 6.00 | × 0.378 | 2.2680 |
| Total RVUs | 48.9299 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$1634.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 32.18 | 1 |
| Practice expense | 15.69 | 0.923 |
| Malpractice | 6 | 0.378 |
(32.18 × 1 + 15.69 × 0.923 + 6 × 0.378) × $33.4009 = $1634.30
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.
45395 billing questions
How does this differ from 45397?
Both describe laparoscopic complete proctectomy with a combined abdominoperineal approach. This code includes colostomy creation; 45397 is the related pouch procedure.
When is the open counterpart more appropriate?
Use the open counterpart, 45110, when the operation is performed open rather than laparoscopically and the documented procedure otherwise matches.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
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.
What postoperative care is included?
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.
5,52545391,,Colonoscopy w/endoscope us,A,,4.52,1.76,NA,1.76,,0.49,6.77,6.77,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52645392,,Colonoscopy w/endoscopic fnb,A,,5.36,1.99,NA,1.99,,0.61,7.96,7.96,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52745393,,Colonoscopy w/decompression,A,,4.56,1.42,NA,1.42,,0.56,6.54,6.54,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,52845395,,Lap removal of rectum,A,,32.18,15.69,NA,15.69,,6.00,53.87,53.87,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,52945397,,Lap remove rectum w/pouch,A,,35.59,16.39,NA,16.39,,6.16,58.14,58.14,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53045398,,Colonoscopy w/band ligation,A,,4.10,22.32,,1.57,,0.60,27.02,6.27,0,000,0.00,0.00,0.00,3,0,1,0,0,9,45378,33.4009,09,0,99,0.00,0.00,0.00
5,53145399,,Unlisted procedure colon,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068