Billing code 45000: Pelvic abscess drainageMedicare rate & RVUs in Oklahoma
Reports operative drainage of a pelvic abscess approached through the rectum, when the abscess location and route match this procedure.
CMS doesn’t publish an office rate for 45000 in Oklahoma.
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 45000 covers
billing code 45000 represents surgical drainage of an abscess located in the pelvis using a transrectal approach. A colorectal or general surgeon may perform it in an operating room when the pelvic collection is reached through the rectum. The key distinction is the pelvic location of the abscess, rather than a collection confined to the rectal wall or perirectal tissues.
Select the code based on the documented abscess location and operative route. The note should identify the pelvic collection and describe drainage through the rectum. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are 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.
45000 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $386.23 |
How the 45000 rate is calculated
Each of 45000’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 · 45000
RVUs × geographic indexes × conversion factor
Work6.14
6.14 RVUs× 1.000 GPCI
Practice expense5.09
5.09 RVUs× 1.000 GPCI
Malpractice1.13
1.13 RVUs× 1.000 GPCI
Adjusted RVUs
12.3600
Conversion factor
$33.4009
Medicare rate
$412.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45000
45000 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45000
Pelvic abscess drainage
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 45000
Pelvic abscess drainage
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
45000 without 51 · national facility
$412.84
Pelvic abscess drainage
45000-51 · Second procedure: 50%
$206.42
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%).
45000 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45005Rectal abscess drainage
- 45000 is for a pelvic abscess drained transrectally. 45005 is for an abscess located in the rectal area and treated by a transanal approach.
- 45020Abscess drainage
- Choose 45020 for perirectal abscess drainage through a transperineal route. 45000 describes transrectal drainage of a pelvic abscess.
- 49407Pelvic drainage
- 49407 describes image-guided catheter drainage by a transrectal or transvaginal route. 45000 is the operative drainage code for a pelvic abscess approached transrectally.
45000 billing questions
How is 45000 distinguished from drainage of a rectal abscess?
Use 45000 when the abscess is pelvic and the operative route is transrectal. A collection confined to the rectum or perirectal tissues points to a different drainage code.
What documentation supports reporting 45000?
Document the pelvic abscess and the transrectal route used to drain it. The operative report should make clear that the target was pelvic, not a rectal or perirectal abscess.
Does the 90-day global period include postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be reported for bilateral drainage?
No. Modifier 50 is inappropriate for this code; report the service for the pelvic drainage rather than as a bilateral procedure.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures performed in that session are paid at 50%. Medicare does not pay an assistant at surgery for 45000.
Can co-surgeons or a surgical team be reported?
No. Medicare does not permit co-surgeons or team surgery for this service.
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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