No office rate
Choose 45500 for injury-related proctoplasty; 45505 is for proctoplasty to address rectal stenosis.
On this page
CMS RVU26D · Effective 2026-10-01
45500 Rectal injury repair Medicare reimbursement rates in Wyoming
Surgical proctoplasty repairs an injury to the rectum, including anorectal sphincter repair when needed, during an operative encounter. Compare 45500 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 45500 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
$552.70
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 45500: Proctoplasty for Rectal Injury
Surgical proctoplasty repairs an injury to the rectum, including anorectal sphincter repair when needed, during an operative encounter.
This operation repairs an injured rectum through a proctoplasty approach; the repair may also involve the anorectal sphincter when that structure is injured. It is typically performed by a colorectal or general surgeon in an operating room for a rectal injury requiring operative repair. The operative report should identify the injury and describe the repair performed, including any sphincter repair.
Report 45500 when the documented service is injury-related proctoplasty, rather than reconstruction for rectal narrowing or repair through a different operative approach. The Medicare 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 multiple procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity.
CMS billing rules for 45500
- 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 RVU7.54 · 44%
- Practice expense (office) RVU7.52 · 44%
- Malpractice RVU2.01 · 12%
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.
45500 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
45562 describes transabdominal exploration and repair of a rectal injury. Use 45500 when the documented operation is the injury-related proctoplasty.
No office rate
45563 describes transabdominal exploration and rectal injury repair with a colostomy. 45500 represents injury-related proctoplasty instead.
Compare 45500 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
$552.70
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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 45500 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,537
- Code
- 45500
- Physician work
- 7.54
- Practice expense
- 7.52
- Malpractice
- 2.01
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.54 | × 1.000 | 7.5400 |
| Practice expense | 7.52 | × 1.000 | 7.5200 |
| Malpractice | 2.01 | × 0.740 | 1.4874 |
| Total RVUs | 16.5474 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$552.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.54 | 1 |
| Practice expense | 7.52 | 1 |
| Malpractice | 2.01 | 0.74 |
(7.54 × 1 + 7.52 × 1 + 2.01 × 0.74) × $33.4009 = $552.70
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.
45500 billing questions
How does 45500 differ from 45505?
45500 is for proctoplasty to repair an injury. 45505 is the related proctoplasty code for treatment of rectal stenosis.
When is 45562 a better fit?
Consider 45562 when the documented service is transabdominal exploration and repair of a rectal injury, rather than the proctoplasty represented by 45500.
Are related postoperative visits separately reported?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
When can an assistant at surgery be reported?
Medicare assistant-at-surgery payment requires documentation that the assistant was medically necessary.
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.
5,5344540F,,Disease modif pharmacothxpy,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
5,5354541F,,Pt offered tx for pseudobulb,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
5,53645499,,Laparoscope proc rectum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53745500,,Repair of rectum,A,,7.54,7.52,NA,7.52,,2.01,17.07,17.07,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,53845505,,Repair of rectum,A,,8.15,8.18,NA,8.18,,1.46,17.79,17.79,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,5394550F,,Noninvas resp support talk,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
5,5404551F,,Nutritional support offered,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
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.,,,,,,