Billing code 45135: Rectal prolapse excisionMedicare rate & RVUs in Ohio
Reports abdominal surgery to excise rectal prolapse, distinguished from perineal excision and from procedures that suspend the rectum without excising it.
CMS doesn’t publish an office rate for 45135 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 45135 covers
This code describes an abdominal operation to remove tissue involved in rectal prolapse. A colorectal or general surgeon typically performs the procedure in a hospital operating room for a patient whose prolapse is being treated through an abdominal approach. The operative report should make the approach and excision clear, and describe the prolapse and any reconstruction performed. It is distinct from perineal excision, which uses a different operative route.
Choose this code when the documented operation excises the prolapsed rectum through an abdominal approach; do not select it solely because the surgeon treats prolapse. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery 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.
45135 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,165.31 |
How the 45135 rate is calculated
Each of 45135’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 · 45135
RVUs × geographic indexes × conversion factor
Work21.80
21.80 RVUs× 1.000 GPCI
Practice expense10.88
10.88 RVUs× 1.000 GPCI
Malpractice3.13
3.13 RVUs× 1.000 GPCI
Adjusted RVUs
35.8100
Conversion factor
$33.4009
Medicare rate
$1,196.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45135
45135 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45135
Rectal prolapse 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 · 45135
Rectal prolapse 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
45135 without 51 · national facility
$1,196.09
Rectal prolapse excision
45135-51 · Second procedure: 50%
$598.05
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%).
45135 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45130Rectal prolapse repair
- Both codes address excision of rectal prolapse, but 45135 uses an abdominal approach and 45130 uses a perineal approach.
- 45540Rectal prolapse repair
- 45540 describes abdominal rectopexy to treat prolapse. Use 45135 when the documented operation includes abdominal excision of prolapsed rectal tissue.
- 45550Rectal repair
- 45550 combines abdominal rectopexy with sigmoid resection. Distinguish it from 45135 by the documented procedure and whether rectopexy with sigmoid resection was performed.
45135 billing questions
How does this differ from 45130?
45135 is for excision of rectal prolapse through an abdominal approach. 45130 describes the perineal approach; follow the operative report rather than the diagnosis alone.
Is rectopexy alone reported with this code?
No. This code describes excision of prolapsed rectal tissue through an abdominal approach. A rectopexy without excision is a different procedure, such as 45540.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation.
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
Fee sheets
Put 45135 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →