Billing code 45172: Rectal tumor excisionMedicare rate & RVUs in Nevada
A colorectal surgeon removes a localized rectal tumor through the anus with a full-thickness segment of rectal wall, typically as definitive local treatment.
CMS doesn’t publish an office rate for 45172 in Nevada.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 45172 covers
A colorectal surgeon excises a rectal tumor through the anus, removing the lesion along with the full thickness of the rectal wall at the operative site. This is a local excision rather than removal of the rectum. The service is generally performed in an operating room for a rectal lesion selected for transanal surgical treatment; the excised tissue is available for pathologic examination.
Report this code when the operative note supports a transanal approach and full-thickness removal of the rectal wall, not a superficial or partial-thickness excision. Document the lesion treated and the extent and route of excision. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this single-organ procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery billing is not permitted.
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.
45172 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $783.22 |
How the 45172 rate is calculated
Each of 45172’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 45172
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.83Practice expense 9.81Malpractice 2.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45172
45172 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45172
Rectal tumor excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 45172
Rectal tumor excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45172 without 51 · national facility
$794.94
Rectal tumor excision
45172-51 · Second procedure: 50%
$397.47
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
45172 compared with similar codes
Compare codes
45172 vs 45171 vs 45160 vs 45100 vs 45190: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45171Rectal tumor excision
- Both codes describe transanal rectal tumor excision. Choose 45172 when the excision includes full-thickness rectal wall; 45171 describes excision without that extent.
- 45160Rectal lesion excision
- This code is for tumor excision through a transsacral or transcoccygeal route. 45172 uses a transanal route and includes full-thickness wall excision.
- 45100Rectal biopsy
- 45100 describes rectal biopsy for tissue sampling. 45172 describes removal of the tumor with full-thickness rectal wall excision.
- 45190Rectal tumor destruction
- 45190 describes destruction of a rectal tumor. 45172 is used when the tumor and full-thickness rectal wall are excised.
45172 billing questions
How does this differ from 45171?
45172 is for transanal excision that removes the full thickness of the rectal wall. Use 45171 for the transanal tumor excision that does not require full-thickness removal.
Is a transanal biopsy reported with this excision?
A biopsy code describes tissue sampling, while 45172 describes definitive full-thickness tumor excision. The operative documentation should establish whether an excision or only a diagnostic sample was performed.
Can modifier 50 be used for tumors on both sides of the rectum?
No. Modifier 50 is inappropriate for this rectal excision; report the service as a single procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for the operation.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery billing is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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