No office rate
Both describe laparoscopic proctopexy for prolapse. Choose 45402 when sigmoid resection is part of the operation; 45400 is for proctopexy without that resection.
On this page
CMS RVU26D · Effective 2026-10-01
45400 Rectopexy Medicare reimbursement rates in Rhode Island
Laparoscopic proctopexy fixes the rectum for rectal prolapse; report this code when the procedure is performed without sigmoid resection. Compare 45400 office and facility rates across CMS payment localities in Rhode Island.
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 45400 in Rhode Island?
Rhode Island 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
$1054.23
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 45400: Laparoscopic proctopexy for rectal prolapse
Laparoscopic proctopexy fixes the rectum for rectal prolapse; report this code when the procedure is performed without sigmoid resection.
This operation uses a laparoscopic approach to secure the rectum in the pelvis for treatment of rectal prolapse. It is typically performed by a colorectal or general surgeon in a hospital or other surgical facility. This code describes proctopexy without sigmoid resection; when sigmoid resection is part of the prolapse operation, a different code applies.
Report the procedure performed, supported by documentation of the prolapse, laparoscopic approach, rectopexy, and whether sigmoid resection was done. The 90-day global period includes 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 others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 45400
- 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 RVU18.95 · 61%
- Practice expense (office) RVU8.96 · 29%
- Malpractice RVU3.36 · 11%
2.3K
Medicare services in 2024 · #2368 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.
45400 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
This code describes abdominal proctopexy by an open approach. Use 45400 when the rectopexy is performed laparoscopically.
No office rate
This code describes open abdominal proctopexy with sigmoid resection. For a laparoscopic repair with resection, compare 45402.
Compare 45400 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$1054.23
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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 45400 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
5,532
- Code
- 45400
- Physician work
- 18.95
- Practice expense
- 8.96
- Malpractice
- 3.36
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.95 | × 1.019 | 19.3100 |
| Practice expense | 8.96 | × 1.033 | 9.2557 |
| Malpractice | 3.36 | × 0.892 | 2.9971 |
| Total RVUs | 31.5628 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1054.23
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.95 | 1.019 |
| Practice expense | 8.96 | 1.033 |
| Malpractice | 3.36 | 0.892 |
(18.95 × 1.019 + 8.96 × 1.033 + 3.36 × 0.892) × $33.4009 = $1054.23
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.
45400 billing questions
When should 45400 be reported instead of 45402?
Use 45400 for laparoscopic proctopexy without sigmoid resection. When sigmoid resection is performed as part of the prolapse operation, use 45402.
Can modifier 50 be used for this procedure?
No. The descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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.
5,52945397,,Lap remove rectum w/pouch,A,,35.59,16.39,NA,16.39,,6.16,58.14,58.14,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53045398,,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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537