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CMS RVU26D · Effective 2026-10-01

45505 Rectal repair Medicare reimbursement rates in Rhode Island

Reports direct surgical closure of a rectal defect approached through the anal canal, such as a localized rectal injury accessible from below. Compare 45505 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 45505 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

$603.12

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.

Find 45505 in your payment locality →

Colorectal surgery

About 45505: Transanal repair of rectal defect

Reports direct surgical closure of a rectal defect approached through the anal canal, such as a localized rectal injury accessible from below.

This service involves reaching a rectal defect through the anal canal and closing it directly. A colorectal or general surgeon may perform it for a localized rectal wall injury or defect that can be exposed and repaired from below, typically in an operating room. The operative approach distinguishes this service from repairs requiring perineal or abdominal access.

Select the code from the approach and work documented, not from the diagnosis alone. The operative report should identify the rectal defect, its location, the transanal access, and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

CMS billing rules for 45505

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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU8.15 · 46%
  • Practice expense (office) RVU8.18 · 46%
  • Malpractice RVU1.46 · 8%

426

Medicare services in 2024 · #3681 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.

45505 compared with similar codes

Office rates for Rhode Island, from the same CMS release.

45500

Rectal injury repair

Injury-related proctoplasty

No office rate

Choose 45505 when the repair is reached through the anal canal; 45500 represents a perineal approach.

45562

Rectal injury repair

Transabdominal exploration

No office rate

45562 describes exploration and repair through an abdominal approach. Use 45505 for a repair performed through the anal canal.

45563

Rectal repair

With colostomy

No office rate

45563 is an abdominal exploration-and-repair option; 45505 is selected for the transanal approach.

45520

Rectal prolapse treatment

Local treatment, any method

$173.66

45520 addresses treatment of rectal prolapse, not direct closure of a rectal defect or injury.

Compare 45505 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

Office and facility base rates · shared scale starting at $0

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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 45505 in Rhode Island.

PPRRVU2026_Oct_nonQPP.csv

5,538

Code
45505
Physician work
8.15
Practice expense
8.18
Malpractice
1.46

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Facility calculation for 45505 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work8.15× 1.0198.3049
Practice expense8.18× 1.0338.4499
Malpractice1.46× 0.8921.3023
Total RVUs18.0571
Conversion factor× 33.4009

Facility rate, Rhode Island$603.12

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work8.151.019
Practice expense8.181.033
Malpractice1.460.892

(8.15 × 1.019 + 8.18 × 1.033 + 1.46 × 0.892) × $33.4009 = $603.12

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.

45505 billing questions

How does this differ from 45500?

The approach is the key distinction: 45505 is for repair reached through the anal canal, while 45500 represents a perineal approach. The operative report should support the approach used.

When would an abdominal repair code be more appropriate?

Use the applicable abdominal exploration-and-repair code when the surgeon explores and repairs the rectum through an abdominal approach. Codes 45562 and 45563 are alternatives to consider for that operative circumstance.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50 for the rectal repair.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The global period is tied to this major surgery.

What documentation supports reporting 45505?

Document the rectal defect or injury, the transanal route used to reach it, and the repair performed. Those details distinguish this service from perineal or abdominal repair.

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.

RVUs for 45505PPRRVU2026_Oct_nonQPP.csv, line 5,538 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet