Billing code 45110: Rectal resectionMedicare rate & RVUs in Ohio
Reports complete removal of the rectum through abdominal and perineal approaches when the operation includes creation of a colostomy.
CMS doesn’t publish an office rate for 45110 in Ohio.
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 45110 covers
This operation removes the rectum through both abdominal and perineal access and includes creation of a colostomy. Colorectal and general surgeons commonly perform it in a hospital operating room, often for rectal cancer when a restorative reconstruction is not planned. The operative report should establish the full extent of rectal removal, both approaches, and the colostomy.
Select this code when the documented operation matches that complete resection and colostomy combination, rather than a partial resection or a different operative approach. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care during the following 90 days. For procedures performed in the same session, Medicare pays the highest-valued procedure in full and reduces other procedures under the standard multiple-procedure rule. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate for this single-organ procedure.
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.
45110 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,631.58 |
How the 45110 rate is calculated
Each of 45110’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 · 45110
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.99Practice expense 14.55Malpractice 5.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 45110
45110 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45110
Rectal resection
| 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 · 45110
Rectal resection
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
45110 without 51 · national facility
$1,672.38
Rectal resection
45110-51 · Second procedure: 50%
$836.19
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%).
45110 compared with similar codes
Compare codes
45110 vs 45111 vs 45112 vs 45121: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45111Partial proctectomy
- Choose 45111 for partial rectal resection with anastomosis; choose 45110 for complete removal with a colostomy through abdominal and perineal approaches.
- 45112Rectal removal
- Both describe complete rectal removal, but 45112 uses a perineal approach rather than the combined abdominal and perineal approach with colostomy represented by 45110.
- 45121Proctocolectomy
- Use 45121 when the documented resection includes colon as well as rectum; 45110 describes the complete rectal resection and colostomy service.
45110 billing questions
How is this code distinguished from 45111?
This code describes complete rectal removal through abdominal and perineal approaches with a colostomy. Code 45111 is for partial removal with an anastomosis.
Is creation of the colostomy included?
Yes. The colostomy is part of the service represented by this code.
What documentation supports code selection?
The operative report should describe complete rectal removal, the abdominal and perineal approaches, and colostomy creation.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this procedure involving a single rectum and operative field.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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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