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CPT 45111: Partial Rectal Resection, Abdominal Approach

CPT code 45111 denotes a partial resection of the rectum performed through an abdominal approach when the diseased segment cannot be safely reached transanally or via the perineum. The code captures a major colorectal surgical procedure commonly employed for Crohn colitis and rectal cancer and is relevant to surgical billing, inpatient quality reporting, and national expenditure for colorectal disease care. Nationally, this procedure is a component of complex colorectal surgery pathways that influence hospital resource use, length of stay, and post-operative care patterns.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context and service setting, typical payer coverage considerations, and commonly reported modifiers. The publication also summarizes benchmark metrics and policy considerations affecting coverage and coding practice. Clinical context covers indications, approach rationale, and expected operative setting; billing context addresses payer mix, reimbursement drivers, and coding nuances relevant to surgical teams and billing departments.

Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, or granular payer-specific reimbursement rates.

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Billing Code Overview

CPT code 45111 describes a partial resection of the rectum performed via an abdominal approach. The procedure is used when the diseased segment of the rectum cannot be accessed safely through an anal or transperineal route. Typical clinical indications include Crohn colitis and rectal cancer.

Service Type: Surgical — Partial rectal resection, abdominal approach

Typical Site of Service: Hospital operating room or inpatient surgical suite

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CPT 45111: Partial Rectal Resection, Abdominal Approach

Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, or granular payer-specific reimbursement rates.

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Get alerted when payer policies referencing 45111 are released or updated.

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Billing Code Overview

Service Type: Surgical — Partial rectal resection, abdominal approach

Typical Site of Service: Hospital operating room or inpatient surgical suite

Clinical & Coding Specifications

Clinical Context

A 62-year-old male with a mid-rectal adenocarcinoma presents with progressive rectal bleeding, tenesmus, and imaging showing a tumor located above the anal canal that cannot be safely accessed transanally. After multidisciplinary review, the colorectal surgeon schedules an elective partial resection of the rectum via an abdominal approach to remove the diseased segment and restore intestinal continuity. The clinical workflow includes preoperative staging (CT chest/abdomen/pelvis), bowel preparation, informed consent documenting indication and planned procedure, anesthesia evaluation, intraoperative abdominal approach with mobilization of the rectum, resection of the involved segment, and either primary anastomosis or creation of a temporary diverting ostomy as indicated. Postoperative care involves pain control, early ambulation, monitoring for anastomotic leak or bleeding, pathology review of the specimen to determine margins and staging, and coordination of adjuvant therapy if malignant disease is confirmed.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier applicable or not provided by payer	Rarely used; default when no other modifier applies and the payer requires a placeholder.
`11`	Professional component	Use when reporting only the surgeon's professional services distinct from facility services if payer requests.
`22`	Increased procedural services	Use when documentation supports substantially greater effort, time, or complexity than typical for the procedure.
`52`	Reduced services	Use when the procedure was partially reduced or not completed as documented (e.g., planned resection aborted).
`53`	Discontinued procedure	Use when the procedure was terminated after initiation for reasons unrelated to patient improvement.
`54`	Surgical care only	Use when only the intraoperative surgical care is billed separately and pre/postoperative care billed by another provider.
`55`	Postoperative management only	Use when only postoperative management is billed and the intraoperative portion billed by another provider.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`63`	Procedure performed on infants less than 4 kg	Rare for this procedure but applicable if performed in neonate/infant meeting weight criteria.
`66`	Surgical team	Use when a surgical team approach is used and payer requires team reporting.
`78`	Return to operating room for a related procedure during the postoperative period	Use when a related unplanned reoperation occurs during the global period.
`80`	Assistant surgeon	Use when an assistant at surgery is billed separately (non-physician assistant/physician as allowed).
`81`	Minimum assistant surgeon	Use when minimum assistant participation is documented and permitted by payer.
`82`	Assistant surgeon (when surgeon assistant unavailable)	Use when a nonqualified assistant is used with payer approval.
`59`	Distinct procedural service	Use when reporting an unrelated procedure or a separate operative service that is distinct and not bundled with the rectal resection.

Taxonomy Code	Specialty	Notes
`207R00000X`	Colon & Rectal Surgery	Primary specialty performing `45111` in most centers.
`208000000X`	General Surgery	General surgeons with colorectal expertise commonly perform abdominal rectal resections.
`207L00000X`	Surgical Oncology	Surgical oncologists perform resections for malignant rectal disease.
`207RC0000X`	Thoracic & Cardiac Surgery	Not typical; included only if thoracoabdominal access required (uncommon).
`363LP0800X`	Anesthesiology	Provides intraoperative anesthesia support and billing for anesthesia services.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C20`	Malignant neoplasm of rectum	Primary indication for partial resection of the rectum via abdominal approach to achieve oncologic resection.
`K50.814`	Crohn disease of large intestine with intestinal obstruction	Crohn colitis with obstructive features can necessitate abdominal rectal resection when transanal access is not feasible.
`K51.212`	Ulcerative colitis, left-sided, with rectal bleeding	Severe inflammatory colitis with complications may require partial proctectomy.
`K62.5`	Hemorrhage of anus and rectum	Significant bleeding from rectal lesions refractory to endoscopic therapy may require surgical resection.
`K57.50`	Diverticulosis of large intestine without perforation or abscess	Complicated diverticular disease involving the rectum/sigmoid may require resection via abdominal approach.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44140`	Colectomy, partial; with anastomosis	Used when tumor extends into the sigmoid or requires partial colectomy in addition to rectal resection.
`44143`	Colectomy, partial; with coloproctostomy (low pelvic anastomosis)	Performed when a low colorectal/coloproctostomy anastomosis is created after resection.
`44160`	Colectomy, partial; with removal of terminal ileum with ileocolostomy	May be performed if disease involves terminal ileum necessitating extended resection.
`44145`	Colectomy, partial; with colostomy or ileostomy	Used when a stoma is created instead of primary anastomosis.
`47562`	Laparoscopy, surgical; cholecystectomy (for concomitant procedures)	Example of a concurrent abdominal procedure sometimes staged or performed during same hospitalization; listed as commonly associated ancillary abdominal procedures.

CPT 45100: Anal Approach Biopsy of Anorectal Wall

CPT-45108-ANORECTAL-TUMOR-EXCISION

CPT 45108: Excision of Anorectal Muscle Tumor

CPT-45110-ABDOMINOPERINEAL-RESECTION-WITH-COLOSTOMY

CPT 45110: Abdominoperineal Resection with Colostomy

CPT-45112-RECTAL-RESECTION-COLON-TO-ANUS-ANASTOMOSIS

CPT 45112: Rectal Resection with Colonic Anastomosis to Anus

CPT-45113-PROCTECTOMY-ILEOANAL-ANASTOMOSIS-ILEAL-POUCH

CPT 45113: Partial Proctectomy with Ileoanal Anastomosis and Ileal Pouch

CPT-45114-RECTAL-RESECTION-ANASTOMOSIS-ABDOMINAL-SACRAL-APPROACH

CPT 45114: Rectal Resection and Colon-Rectal Anastomosis, Abdominal and Sacral Approach

CPT-45116-POSTERIOR-APPROACH-RECTAL-RESECTION-ANASTOMOSIS

CPT 45116: Posterior Rectal Resection with Colorectal Anastomosis

CPT-45119-RESTORATIVE-PROCTOCOLECTOMY-WITH-COLONIC-POUCH

CPT 45119: Restorative Proctocolectomy with Colonic Pouch

CPT-45120-ABDOMINOPERINEAL-RECTAL-RESECTION-COLON-ANASTOMOSIS

CPT 45120: Abdominoperineal Rectal Resection with Colon-Anus Anastomosis

CPT-45121-PULL-THROUGH-RESECTION-ABDOMINAL-PERINEAL-COLORECTAL-ANASTOMOSIS

CPT 45121: Pull-Through Resection with Colorectal Anastomosis

Showing 1–10 of 19

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier applicable or not provided by payer	Rarely used; default when no other modifier applies and the payer requires a placeholder.
`11`	Professional component	Use when reporting only the surgeon's professional services distinct from facility services if payer requests.
`22`	Increased procedural services	Use when documentation supports substantially greater effort, time, or complexity than typical for the procedure.
`52`	Reduced services	Use when the procedure was partially reduced or not completed as documented (e.g., planned resection aborted).
`53`	Discontinued procedure	Use when the procedure was terminated after initiation for reasons unrelated to patient improvement.
`54`	Surgical care only	Use when only the intraoperative surgical care is billed separately and pre/postoperative care billed by another provider.
`55`	Postoperative management only	Use when only postoperative management is billed and the intraoperative portion billed by another provider.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`63`	Procedure performed on infants less than 4 kg	Rare for this procedure but applicable if performed in neonate/infant meeting weight criteria.
`66`	Surgical team	Use when a surgical team approach is used and payer requires team reporting.
`78`	Return to operating room for a related procedure during the postoperative period	Use when a related unplanned reoperation occurs during the global period.
`80`	Assistant surgeon	Use when an assistant at surgery is billed separately (non-physician assistant/physician as allowed).
`81`	Minimum assistant surgeon	Use when minimum assistant participation is documented and permitted by payer.
`82`	Assistant surgeon (when surgeon assistant unavailable)	Use when a nonqualified assistant is used with payer approval.
`59`	Distinct procedural service	Use when reporting an unrelated procedure or a separate operative service that is distinct and not bundled with the rectal resection.

Taxonomy Code	Specialty	Notes
`207R00000X`	Colon & Rectal Surgery	Primary specialty performing `45111` in most centers.
`208000000X`	General Surgery	General surgeons with colorectal expertise commonly perform abdominal rectal resections.
`207L00000X`	Surgical Oncology	Surgical oncologists perform resections for malignant rectal disease.
`207RC0000X`	Thoracic & Cardiac Surgery	Not typical; included only if thoracoabdominal access required (uncommon).
`363LP0800X`	Anesthesiology	Provides intraoperative anesthesia support and billing for anesthesia services.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C20`	Malignant neoplasm of rectum	Primary indication for partial resection of the rectum via abdominal approach to achieve oncologic resection.
`K50.814`	Crohn disease of large intestine with intestinal obstruction	Crohn colitis with obstructive features can necessitate abdominal rectal resection when transanal access is not feasible.
`K51.212`	Ulcerative colitis, left-sided, with rectal bleeding	Severe inflammatory colitis with complications may require partial proctectomy.
`K62.5`	Hemorrhage of anus and rectum	Significant bleeding from rectal lesions refractory to endoscopic therapy may require surgical resection.
`K57.50`	Diverticulosis of large intestine without perforation or abscess	Complicated diverticular disease involving the rectum/sigmoid may require resection via abdominal approach.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44140`	Colectomy, partial; with anastomosis	Used when tumor extends into the sigmoid or requires partial colectomy in addition to rectal resection.
`44143`	Colectomy, partial; with coloproctostomy (low pelvic anastomosis)	Performed when a low colorectal/coloproctostomy anastomosis is created after resection.
`44160`	Colectomy, partial; with removal of terminal ileum with ileocolostomy	May be performed if disease involves terminal ileum necessitating extended resection.
`44145`	Colectomy, partial; with colostomy or ileostomy	Used when a stoma is created instead of primary anastomosis.
`47562`	Laparoscopy, surgical; cholecystectomy (for concomitant procedures)	Example of a concurrent abdominal procedure sometimes staged or performed during same hospitalization; listed as commonly associated ancillary abdominal procedures.

CPT 45100: Anal Approach Biopsy of Anorectal Wall

CPT-45108-ANORECTAL-TUMOR-EXCISION

CPT 45108: Excision of Anorectal Muscle Tumor

CPT-45110-ABDOMINOPERINEAL-RESECTION-WITH-COLOSTOMY

CPT 45110: Abdominoperineal Resection with Colostomy

CPT-45112-RECTAL-RESECTION-COLON-TO-ANUS-ANASTOMOSIS

CPT 45112: Rectal Resection with Colonic Anastomosis to Anus

CPT-45113-PROCTECTOMY-ILEOANAL-ANASTOMOSIS-ILEAL-POUCH

CPT 45113: Partial Proctectomy with Ileoanal Anastomosis and Ileal Pouch

CPT-45114-RECTAL-RESECTION-ANASTOMOSIS-ABDOMINAL-SACRAL-APPROACH

CPT 45114: Rectal Resection and Colon-Rectal Anastomosis, Abdominal and Sacral Approach

CPT-45116-POSTERIOR-APPROACH-RECTAL-RESECTION-ANASTOMOSIS

CPT 45116: Posterior Rectal Resection with Colorectal Anastomosis

CPT-45119-RESTORATIVE-PROCTOCOLECTOMY-WITH-COLONIC-POUCH

CPT 45119: Restorative Proctocolectomy with Colonic Pouch

CPT-45120-ABDOMINOPERINEAL-RECTAL-RESECTION-COLON-ANASTOMOSIS

CPT 45120: Abdominoperineal Rectal Resection with Colon-Anus Anastomosis

CPT-45121-PULL-THROUGH-RESECTION-ABDOMINAL-PERINEAL-COLORECTAL-ANASTOMOSIS

CPT 45121: Pull-Through Resection with Colorectal Anastomosis

Showing 1–10 of 19

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 45111: Partial Rectal Resection, Abdominal Approach

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Billing Code Overview

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CPT 45111: Partial Rectal Resection, Abdominal Approach

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References