CPT code 45400: Rectopexy2026 Medicare rate & RVUs in Virginia
Laparoscopic proctopexy fixes the rectum for rectal prolapse; report this code when the procedure is performed without sigmoid resection.
CMS doesn’t publish an office rate for 45400 in Virginia.
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 45400 covers
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.
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 45400 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $1,144.58 |
| Virginia | Unavailable | $1,006.36 |
How the 45400 rate is calculated
Each of 45400’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 · 45400
RVUs × geographic indexes × conversion factor
Work18.95
18.95 RVUs× 1.000 GPCI
Practice expense8.96
8.96 RVUs× 1.000 GPCI
Malpractice3.36
3.36 RVUs× 1.000 GPCI
Adjusted RVUs
31.2700
Conversion factor
$33.4009
Medicare rate
$1,044.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45400
45400 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45400
Rectopexy
| 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 · 45400
Rectopexy
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
45400 without 51 · national facility
$1,044.45
Rectopexy
45400-51 · Second procedure: 50%
$522.23
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%).
45400 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45402Laparoscopic rectopexy
- Both describe laparoscopic proctopexy for prolapse. Choose 45402 when sigmoid resection is part of the operation; 45400 is for proctopexy without that resection.
- 45540Rectal prolapse repair
- This code describes abdominal proctopexy by an open approach. Use 45400 when the rectopexy is performed laparoscopically.
- 45550Rectal repair
- This code describes open abdominal proctopexy with sigmoid resection. For a laparoscopic repair with resection, compare 45402.
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 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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