Billing code 45915: Rectal obstruction removalMedicare rate & RVUs in Washington
Report this service when a clinician removes obstructing stool or a foreign body from the rectum under anesthesia.
Medicare pays $414.67–$468.20 for 45915 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 45915 covers
This service covers removal of obstructing material from the rectum when the work is performed under anesthesia. Typical cases include a substantial fecal impaction or a rectal foreign body that requires procedural extraction rather than routine office or bedside care. Colorectal and general surgeons commonly perform it in a hospital or ambulatory surgical setting; the clinical record should identify the obstruction and describe the removal performed.
Select the code for the extraction itself, not for treatment of a narrowing, sphincter problem, or prolapse that may cause obstructive symptoms. Document the material removed, the anatomic site, the technique, and the use of anesthesia. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are 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 45915 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $414.67 | $233.89 |
| Seattle (King Cnty) | $468.20 | $257.54 |
How the 45915 rate is calculated
Each of 45915’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 · 45915
RVUs × geographic indexes × conversion factor
Work3.11
3.11 RVUs× 1.000 GPCI
Practice expense8.35
8.35 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
12.0800
Conversion factor
$33.4009
Medicare rate
$403.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 45915
45915 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 45915
Rectal obstruction removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 45915
Rectal obstruction removal
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
45915 without 51 · national office
$403.48
Rectal obstruction removal
45915-51 · Second procedure: 50%
$201.74
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%).
45915 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 45910Rectal dilation
- Choose 45915 for extraction of obstructing material. Choose 45910 when the intervention dilates a rectal narrowing.
- 45905Anal dilation
- 45905 is for dilation of the anal sphincter; 45915 removes obstructing material from the rectum under anesthesia.
- 45900Prolapse reduction
- 45900 addresses reduction of rectal prolapse. It is not the extraction code for fecal impaction or a rectal foreign body.
45915 billing questions
When should this code be chosen instead of rectal dilation?
Use this code when the service removes obstructing material from the rectum. Code 45910 describes dilation of a rectal narrowing, rather than extraction.
Does the code include anesthesia?
The service is defined as being performed under anesthesia. Document the anesthesia and the extraction performed; this code does not represent a separately reported anesthesia service.
Can modifier 50 be used?
No. The code’s descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Related postoperative visits during the 10-day global period are included.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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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