No office rate
Use 45563 when the transabdominal injury repair includes a colostomy. 45562 describes the related repair without that additional procedure.
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CMS RVU26D · Effective 2026-10-01
45562 Rectal injury repair Medicare reimbursement rates in Texas
Reports operative abdominal exploration and repair for rectal injury when the surgeon must assess and treat the injury through a transabdominal approach. Compare 45562 office and facility rates across CMS payment localities in Texas.
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 45562 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 45562 pays more and less in Texas
Colorectal surgery
About 45562: Transabdominal rectal injury exploration and repair
Reports operative abdominal exploration and repair for rectal injury when the surgeon must assess and treat the injury through a transabdominal approach.
A surgeon uses an abdominal approach to inspect the rectum and repair an injury that requires operative treatment. This may arise after trauma or as a complication of another procedure. General and colorectal surgeons typically perform the service in an operating room, usually in a facility setting. The operative work centers on identifying the injury and repairing it, rather than treating rectal prolapse or a rectocele.
Documentation should identify the injury, its location and extent, the abdominal approach, and the repair performed. The related 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 other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 45562
- 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 RVU17.53 · 52%
- Practice expense (office) RVU11.41 · 34%
- Malpractice RVU4.69 · 14%
100
Medicare services in 2024 · #4884 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.
45562 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
45500 covers a different rectal repair circumstance. 45562 is for operative abdominal exploration and repair of a rectal injury.
No office rate
45505 is another rectal repair option, not the transabdominal injury exploration service represented by 45562.
Compare 45562 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $1128.69 |
| Beaumont | Office Unavailable | Facility $1077.85 |
| Brazoria | Office Unavailable | Facility $1090.06 |
| Dallas | Office Unavailable | Facility $1104.77 |
| Fort Worth | Office Unavailable | Facility $1103.00 |
| Galveston | Office Unavailable | Facility $1098.34 |
| Houston | Office Unavailable | Facility $1184.19 |
| Rest Of Texas | Office Unavailable | Facility $1088.64 |
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45562 billing questions
How does 45562 differ from 45563?
45563 is the related option when the rectal injury repair is performed with a colostomy. Use 45562 when the documented service is the transabdominal exploration and repair without that additional procedure.
What documentation supports reporting 45562?
The operative report should describe the rectal injury, its location and extent, the transabdominal approach, and the repair performed.
Can modifier 50 be used?
No. The service is not reported bilaterally, so modifier 50 is inappropriate.
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.
Can an assistant or co-surgeon be reported?
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 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.
5,54745550,,Repair rectum/remove sigmoid,A,,24.18,11.73,NA,11.73,,4.58,40.49,40.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5484555F,,Pt recvd no inhal anesthic,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
5,54945560,,Repair of rectocele,A,,11.21,5.84,NA,5.84,,1.92,18.97,18.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,55045562,,Exploration/repair of rectum,A,,17.53,11.41,NA,11.41,,4.69,33.63,33.63,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,55145563,,Exploration/repair of rectum,A,,25.72,14.42,NA,14.42,,6.86,47.00,47.00,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5524556F,,Pt w/3+ post-op nausea&vom,M,,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
5,5534557F,,Pt w/o 3+ post-opnausea&vom,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