No office rate
Choose 45400 for laparoscopic rectopexy without sigmoid resection. The resection is the key distinction for 45402.
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CMS RVU26D · Effective 2026-10-01
45402 Laparoscopic rectopexy Medicare reimbursement rates in Ohio
Reports laparoscopic fixation of a prolapsing rectum combined with sigmoid colon resection, typically as operative treatment for full-thickness rectal prolapse. Compare 45402 office and facility rates across CMS payment localities in Ohio.
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 45402 in Ohio?
Ohio 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
$1362.66
1 of 1 localities have a supported rate.
Payment area: Ohio
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 45402: Laparoscopic rectopexy with sigmoid resection
Reports laparoscopic fixation of a prolapsing rectum combined with sigmoid colon resection, typically as operative treatment for full-thickness rectal prolapse.
The surgeon uses laparoscopic abdominal access to mobilize and secure the prolapsing rectum and remove a segment of sigmoid colon. This combined operation is used to treat rectal prolapse, including cases where sigmoid resection is part of the operative plan. It is generally performed by a colorectal or general surgeon in a hospital operating room, with the patient under general anesthesia.
Report this code when the operative record supports both laparoscopic rectopexy for prolapse and sigmoid resection; the resection distinguishes it from laparoscopic rectopexy without resection. Documentation should identify the approach, rectal prolapse, and the resection performed. CMS 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 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45402
- 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 RVU25.85 · 62%
- Practice expense (office) RVU10.84 · 26%
- Malpractice RVU5.01 · 12%
275
Medicare services in 2024 · #4059 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.
45402 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
45550 describes abdominal rectopexy with sigmoid resection using an open approach; 45402 is the laparoscopic approach.
No office rate
45540 is open abdominal rectopexy without sigmoid resection. 45402 includes sigmoid resection and uses laparoscopic access.
Compare 45402 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
Ohio →
Office / nonfacility
Unavailable
Facility
$1362.66
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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 45402 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,533
- Code
- 45402
- Physician work
- 25.85
- Practice expense
- 10.84
- Malpractice
- 5.01
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.85 | × 1.000 | 25.8500 |
| Practice expense | 10.84 | × 0.913 | 9.8969 |
| Malpractice | 5.01 | × 1.008 | 5.0501 |
| Total RVUs | 40.7970 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1362.66
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.85 | 1 |
| Practice expense | 10.84 | 0.913 |
| Malpractice | 5.01 | 1.008 |
(25.85 × 1 + 10.84 × 0.913 + 5.01 × 1.008) × $33.4009 = $1362.66
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.
45402 billing questions
When should 45402 be chosen instead of 45400?
Use 45402 when laparoscopic rectopexy for prolapse is performed with sigmoid colon resection. Use 45400 for laparoscopic rectopexy without that resection.
Is the sigmoid resection separately reported?
The resection is part of the combined service represented by 45402. Do not separately report another code for the same sigmoid resection.
What documentation supports 45402?
The operative report should establish rectal prolapse, laparoscopic access, rectopexy, and sigmoid resection. The record should distinguish the procedure from rectopexy without resection.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
5,53045398,,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
5,53245400,,Laparoscopic proc,A,,18.95,8.96,NA,8.96,,3.36,31.27,31.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53345402,,Lap proctopexy w/sig resect,A,,25.85,10.84,NA,10.84,,5.01,41.70,41.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5344540F,,Disease modif pharmacothxpy,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5354541F,,Pt offered tx for pseudobulb,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53645499,,Laparoscope proc rectum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703