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CPT 45400: Laparoscopic Repair of Rectal Prolapse with Sutures and Mesh

CPT code 45400 represents a laparoscopic surgical procedure to repair rectal prolapse with sutures and mesh. This code captures a minimally invasive approach to restore pelvic support and reduce prolapse symptoms. Nationally, procedures for rectal prolapse are significant due to an aging population and increasing use of minimally invasive surgical techniques that affect utilization, care pathways, and facility planning.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for CPT code 45400, common sites of service, and how this service is typically classified. The publication summarizes payer coverage considerations, typical billing modifiers used with surgical laparoscopy, and expected coding relationships. It also outlines benchmarking topics such as utilization patterns, allowed amounts, and site-of-service distribution where available.

This resource is intended to inform coding, billing, and administrative staff, as well as clinicians and policy analysts, about the procedural definition, operational settings, and areas to monitor for reimbursement and policy updates. Data not available in the input will be noted where applicable.

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Billing Code Overview

CPT code 45400 describes a laparoscopic repair of rectal prolapse using sutures and mesh. The procedure involves surgical correction of rectal prolapse through minimally invasive (laparoscopic) techniques with placement of sutures and prosthetic mesh to restore pelvic support.

Service Type: Surgical — Laparoscopic pelvic surgery

Typical Site of Service: Hospital outpatient department or ambulatory surgery center

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CPT 45400: Laparoscopic Repair of Rectal Prolapse with Sutures and Mesh

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Billing Code Overview

Service Type: Surgical — Laparoscopic pelvic surgery

Typical Site of Service: Hospital outpatient department or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 68-year-old female presents with symptomatic full-thickness rectal prolapse characterized by fecal urgency, mucous discharge, and a reducible protrusion during Valsalva. Conservative measures including pelvic floor physical therapy and stool softeners have failed. The colorectal surgeon schedules a laparoscopic rectopexy with mesh reinforcement under general anesthesia. Preoperative steps include colonoscopy (to exclude synchronous lesions), bowel prep per facility protocol, and medical optimization for comorbidities (hypertension, type 2 diabetes). Intraoperatively, the abdomen is insufflated, laparoscopic ports are placed, the rectum is mobilized, posterior sutures are placed to pex the rectum to the sacral promontory, and a biologic or synthetic mesh is affixed laparoscopically to reinforce the repair. The patient is monitored post-anesthesia in a same-day surgery unit or admitted overnight for pain control and return of bowel function. Typical follow-up includes wound checks and evaluation of bowel and continence function at 2–6 weeks and long-term surveillance for recurrence or mesh-related complications.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Applied when no additional modifier is appropriate for the claim
`22`	Increased procedural services	Use when intraoperative complexity or additional work substantially increases the service beyond typical expectations
`52`	Reduced services	Use when the procedure was partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when the procedure is terminated due to patient condition or intraoperative complication before completion
`59`	Distinct procedural service	Use when a separate, distinct procedure was performed on the same day at a separate anatomical site or session
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct portions of the procedure concurrently
`66`	Surgical team (multiple surgeons)	Use when a surgical team of more than two surgeons is documented and appropriate
`80`	Assistant surgeon	Use when a surgical assistant (non-physician or physician assistant) performs part of the operative work under direct supervision
`81`	Minimum assistant surgeon	Use when a minimal assistant is documented assisting the primary surgeon
`AS`	Ambulatory surgical center (facility)	Use to indicate the service occurred in an ambulatory surgical center when required by payer
`26`	Professional component	Rarely used for this procedure; use only if reporting a separately identifiable professional interpretation service
`51`	Multiple procedures	Use when additional CPT procedures are billed on the same day and payer rules require a multiple-procedure modifier
`62`	Two surgeons	(Listed above) Use when two surgeons from different specialties perform distinct portions of the procedure concurrently
`59`	Distinct procedural service	(Listed above) Use to indicate a separate and distinct procedure was performed

Taxonomy Code	Specialty	Notes
207R00000X	Colon and Rectal Surgery	Primary specialty performing laparoscopic rectopexy procedures
207L00000X	General Surgery	Common specialty that performs laparoscopic rectal prolapse repairs in many settings
207EP0101X	Pediatric Surgery	Performs rectopexy in pediatric patients with prolapse when applicable
207K00000X	Obstetrics and Gynecology	May participate in combined pelvic floor repairs where gynecologic procedures are concurrent
2085P0800X	Surgery - Minimally Invasive	Used by surgeons specializing in laparoscopic and minimally invasive approaches

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K62.8`	Other specified diseases of anus and rectum	May capture rectal prolapse manifestations such as mucosal prolapse when a more specific code is not used
`K62.9`	Disease of anus and rectum, unspecified	Occasionally used when documentation lacks specificity for the type of prolapse
`R15.9`	Full incontinence of feces, unspecified	Symptom commonly associated with advanced rectal prolapse and addressed by repair
`R10.9`	Unspecified abdominal pain	May be listed as a presenting symptom in patients with prolapse-related discomfort
`N39.3`	Stress urinary incontinence (female)	May be present as a concurrent pelvic floor disorder in patients undergoing combined repairs

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44388`	Laparoscopy, surgical; colectomy, partial, with anastomosis	Performed if an extended resection is required for concurrent colonic pathology discovered during evaluation or surgery
`45330`	Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen	Preoperative or intraoperative diagnostic evaluation of distal colon and rectum
`51702`	Complex uroflowmetry or pelvic floor testing (placeholder for anorectal manometry code)	Functional testing such as anorectal manometry or colonic transit studies are often performed pre- or postoperatively (note: use appropriate facility-specific CPT for anorectal manometry)
`49587`	Repair recurrent incisional hernia, open or laparoscopic, with or without mesh	Related when concurrent abdominal wall or trocar-site hernia repair is performed during the same operative session
`99024`	Postoperative follow-up visit, global period (note: not billed separately during global)	Relates to routine postoperative care visits included in the global surgical package

CPT 45402: Laparoscopic Sigmoid Resection with Rectal Prolapse Repair

CPT-45499-LAPAROSCOPIC-RECTAL-PROCEDURE-UNLISTED

CPT 45499: Laparoscopic Rectal Procedure, Unlisted

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 (default)	Applied when no additional modifier is appropriate for the claim
`22`	Increased procedural services	Use when intraoperative complexity or additional work substantially increases the service beyond typical expectations
`52`	Reduced services	Use when the procedure was partially reduced or not completed as originally planned
`53`	Discontinued procedure	Use when the procedure is terminated due to patient condition or intraoperative complication before completion
`59`	Distinct procedural service	Use when a separate, distinct procedure was performed on the same day at a separate anatomical site or session
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct portions of the procedure concurrently
`66`	Surgical team (multiple surgeons)	Use when a surgical team of more than two surgeons is documented and appropriate
`80`	Assistant surgeon	Use when a surgical assistant (non-physician or physician assistant) performs part of the operative work under direct supervision
`81`	Minimum assistant surgeon	Use when a minimal assistant is documented assisting the primary surgeon
`AS`	Ambulatory surgical center (facility)	Use to indicate the service occurred in an ambulatory surgical center when required by payer
`26`	Professional component	Rarely used for this procedure; use only if reporting a separately identifiable professional interpretation service
`51`	Multiple procedures	Use when additional CPT procedures are billed on the same day and payer rules require a multiple-procedure modifier
`62`	Two surgeons	(Listed above) Use when two surgeons from different specialties perform distinct portions of the procedure concurrently
`59`	Distinct procedural service	(Listed above) Use to indicate a separate and distinct procedure was performed

Taxonomy Code	Specialty	Notes
207R00000X	Colon and Rectal Surgery	Primary specialty performing laparoscopic rectopexy procedures
207L00000X	General Surgery	Common specialty that performs laparoscopic rectal prolapse repairs in many settings
207EP0101X	Pediatric Surgery	Performs rectopexy in pediatric patients with prolapse when applicable
207K00000X	Obstetrics and Gynecology	May participate in combined pelvic floor repairs where gynecologic procedures are concurrent
2085P0800X	Surgery - Minimally Invasive	Used by surgeons specializing in laparoscopic and minimally invasive approaches

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K62.8`	Other specified diseases of anus and rectum	May capture rectal prolapse manifestations such as mucosal prolapse when a more specific code is not used
`K62.9`	Disease of anus and rectum, unspecified	Occasionally used when documentation lacks specificity for the type of prolapse
`R15.9`	Full incontinence of feces, unspecified	Symptom commonly associated with advanced rectal prolapse and addressed by repair
`R10.9`	Unspecified abdominal pain	May be listed as a presenting symptom in patients with prolapse-related discomfort
`N39.3`	Stress urinary incontinence (female)	May be present as a concurrent pelvic floor disorder in patients undergoing combined repairs

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44388`	Laparoscopy, surgical; colectomy, partial, with anastomosis	Performed if an extended resection is required for concurrent colonic pathology discovered during evaluation or surgery
`45330`	Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen	Preoperative or intraoperative diagnostic evaluation of distal colon and rectum
`51702`	Complex uroflowmetry or pelvic floor testing (placeholder for anorectal manometry code)	Functional testing such as anorectal manometry or colonic transit studies are often performed pre- or postoperatively (note: use appropriate facility-specific CPT for anorectal manometry)
`49587`	Repair recurrent incisional hernia, open or laparoscopic, with or without mesh	Related when concurrent abdominal wall or trocar-site hernia repair is performed during the same operative session
`99024`	Postoperative follow-up visit, global period (note: not billed separately during global)	Relates to routine postoperative care visits included in the global surgical package

CPT 45402: Laparoscopic Sigmoid Resection with Rectal Prolapse Repair

CPT-45499-LAPAROSCOPIC-RECTAL-PROCEDURE-UNLISTED

CPT 45499: Laparoscopic Rectal Procedure, Unlisted

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.

OpenPayer

CPT 45400: Laparoscopic Repair of Rectal Prolapse with Sutures and Mesh

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Billing Code Overview

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OpenPayer

CPT 45400: Laparoscopic Repair of Rectal Prolapse with Sutures and Mesh

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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