CPT code 45550: Rectal repair2026 Medicare rate & RVUs in Oregon
Reports an abdominal rectal repair performed with sigmoid colon resection, commonly during operative treatment of rectal prolapse when both procedures are part of the same operation.
CMS doesn’t publish an office rate for 45550 in Oregon.
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 45550 covers
A colorectal or general surgeon performs this abdominal operation to repair or support the rectum while removing a segment of sigmoid colon. A common setting is surgery for rectal prolapse when the surgeon also resects sigmoid colon, such as when the sigmoid is redundant. The operative report should make clear that both the rectal repair and sigmoid resection were performed; the code is not selected just because a patient has rectal prolapse or undergoes a sigmoid resection alone.
Report the service for the combined work documented in the operative note, including the abdominal approach, rectal repair, and sigmoid resection. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this operation. Assistant-at-surgery payment may be available; 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.
Where 45550 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,369.65 |
| Rest Of Oregon | Unavailable | $1,305.40 |
How the 45550 rate is calculated
Each of 45550’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 · 45550
RVUs × geographic indexes × conversion factor
Work24.18
24.18 RVUs× 1.000 GPCI
Practice expense11.73
11.73 RVUs× 1.000 GPCI
Malpractice4.58
4.58 RVUs× 1.000 GPCI
Adjusted RVUs
40.4900
Conversion factor
$33.4009
Medicare rate
$1,352.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45550
45550 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45550
Rectal repair
| 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 · 45550
Rectal repair
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
45550 without 51 · national facility
$1,352.40
Rectal repair
45550-51 · Second procedure: 50%
$676.20
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%).
45550 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45505Rectal repair
- 45505 covers rectal repair by a transsacral or abdominal approach without the sigmoid resection included in 45550.
- 45540Rectal prolapse repair
- Choose 45540 for abdominal rectal prolapse repair without sigmoid resection; 45550 applies when the abdominal repair and sigmoid resection are both performed.
- 45541Prolapse repair
- 45541 is used for rectal prolapse repair through a perineal approach. 45550 describes an abdominal operation that includes sigmoid resection.
- 45520Rectal prolapse treatment
- 45520 is an external-approach prolapse treatment, unlike the abdominal rectal repair with sigmoid resection reported with 45550.
45550 billing questions
How does this differ from 45540?
45550 includes sigmoid resection with the abdominal rectal repair. 45540 is an abdominal repair for rectal prolapse without that sigmoid resection component.
When would 45541 be considered instead?
45541 describes rectal prolapse repair through a perineal approach. Use 45550 when the documented operation uses an abdominal approach and includes sigmoid resection.
Can the sigmoid resection and rectal repair be reported separately?
This code represents the combined rectal repair and sigmoid resection service. Do not separately report another code for the same work; evaluate any distinct additional procedure on its own documentation.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this rectal operation, and a bilateral adjustment does not apply.
What operative documentation supports 45550?
Document the abdominal approach, the rectal repair or support performed, and the sigmoid colon resection. The note should distinguish this combined operation from prolapse repair without sigmoid resection.
How are assistant and co-surgeon claims handled?
Assistant-at-surgery payment may be available. 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 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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