No office rate
45910 describes dilation of a rectal stricture. Use 45150 when the surgeon excises the stenotic tissue instead of only stretching the narrowed passage.
On this page
CMS RVU26D · Effective 2026-10-01
45150 Stricture excision Medicare reimbursement rates in Wyoming
Report rectal stricture excision when a surgeon removes scarred tissue causing a narrowed rectal passage rather than treating the narrowing by dilation alone. Compare 45150 office and facility rates across CMS payment localities in Wyoming.
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 45150 in Wyoming?
Wyoming 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
$405.07
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 45150: Rectal stricture excision
Report rectal stricture excision when a surgeon removes scarred tissue causing a narrowed rectal passage rather than treating the narrowing by dilation alone.
A colorectal or general surgeon removes tissue responsible for a fixed narrowing of the rectum, typically through a transanal approach. The procedure treats a symptomatic stricture that impedes passage through the rectum; it is distinct from simply stretching the narrowed area. It is generally performed in a surgical facility rather than as an office service.
Choose this code when the operative report supports excision of the stenotic tissue, not dilation alone, biopsy, or removal of a separate rectal lesion. Documentation should identify the stricture, its location and extent, the approach, and the tissue removed. This major surgery 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 inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 45150
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.70 · 46%
- Practice expense (office) RVU5.31 · 42%
- Malpractice RVU1.51 · 12%
20
Medicare services in 2024 · #5920 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.
45150 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
45100 is for biopsy of rectal tissue. It does not represent definitive excision of tissue causing a stricture.
45160
No office rateRectal lesion excision
45160 describes excision of a rectal lesion. Choose 45150 when the operative target is the stricture itself, rather than a separate lesion.
Compare 45150 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$405.07
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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 45150 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,480
- Code
- 45150
- Physician work
- 5.70
- Practice expense
- 5.31
- Malpractice
- 1.51
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.70 | × 1.000 | 5.7000 |
| Practice expense | 5.31 | × 1.000 | 5.3100 |
| Malpractice | 1.51 | × 0.740 | 1.1174 |
| Total RVUs | 12.1274 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$405.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.7 | 1 |
| Practice expense | 5.31 | 1 |
| Malpractice | 1.51 | 0.74 |
(5.7 × 1 + 5.31 × 1 + 1.51 × 0.74) × $33.4009 = $405.07
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.
45150 billing questions
How is excision different from dilation of a rectal stricture?
Use this code when the surgeon removes tissue causing the narrowing. Dilation, which stretches the narrowed area without excising the stricture, is reported with 45910.
Can a rectal biopsy be reported instead?
A biopsy code describes tissue sampling for diagnosis, not definitive removal of stenotic tissue. Report 45150 when the operative service is excision of the stricture.
Is modifier 50 appropriate for a stricture on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code because the descriptor or anatomy does not support modifier 50.
What documentation supports reporting this code?
The operative note should establish a rectal stricture and describe its location, extent, approach, and excision of the stenotic tissue. Dilation alone does not support this code.
When may an assistant-at-surgery be paid?
Assistant-at-surgery payment is available only when the record documents medical necessity. Co-surgeon and team-surgery payment are not permitted for this code.
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.
5,47745130,,Excision of rectal prolapse,A,,18.04,8.80,NA,8.80,,3.24,30.08,30.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47845135,,Excision of rectal prolapse,A,,21.80,10.88,NA,10.88,,3.13,35.81,35.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,47945136,,Excise ileoanal reservior,A,,30.05,14.58,NA,14.58,,4.32,48.95,48.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48045150,,Excision of rectal stricture,A,,5.70,5.31,NA,5.31,,1.51,12.52,12.52,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48145160,,Excision of rectal lesion,A,,15.92,9.06,NA,9.06,,4.25,29.23,29.23,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48245171,,Exc rect tum transanal part,A,,7.93,8.83,NA,8.83,,1.56,18.32,18.32,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,48345172,,Exc rect tum transanal full,A,,11.83,9.81,NA,9.81,,2.16,23.80,23.80,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,