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    v1.0.30
    OpenPayerBilling CodesRepair Procedures on the RectumCPT cpt-45540-abdominal-rectopexy-rectal-prolapse-mesh-suture
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    CPT 45540: Abdominal Repair of Rectal Prolapse with Suture and Mesh

    Medicare pays $988 on average nationally for this procedure.

    CPT code 45540 describes an open abdominal surgical procedure for repair of rectal prolapse in which the surgeon makes an incision in the lower abdomen and restores rectal anatomy using sutures and prosthetic mesh; the service is an abdominal surgical repair of rectal prolapse typically performed in an inpatient or outpatient hospital operating room or ambulatory surgery center depending on clinical status and facility capabilities.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old female with a symptomatic full-thickness rectal prolapse presents for elective operative repair. She reports fecal urgency, mucous discharge, and difficulty with hygiene. Conservative measures including stool softeners and pelvic floor therapy provided partial relief. Preoperative evaluation includes colonoscopy to exclude intraluminal disease, cardiopulmonary assessment, and bowel preparation as indicated. The patient is scheduled for an open abdominal rectopexy with mesh reinforcement under general anesthesia. Intraoperative workflow: midline or lower transverse abdominal incision is made, rectum is mobilized, redundant rectum is reduced, sutures placed to suspend the rectum to the presacral fascia, and a surgical mesh is affixed to reinforce the repair. Hemostasis is confirmed, bowel viability assessed, and abdomen closed in layers. Postoperative care includes pain control, DVT prophylaxis, early ambulation, stool regimen to avoid constipation, and wound monitoring. Typical site of service is an inpatient hospital operating room or ambulatory surgery center for selected low-risk patients.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    45540Resection or repair of rectal prolapse via abdominal approach; suture rectopexy with meshPrimary procedure described; open abdominal rectopexy with mesh fixation
    45378Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washingPreoperative diagnostic colonoscopy to exclude mucosal disease prior to rectopexy
    44120Enterectomy, resection of small intestine; single resection and anastomosisPerformed in rare cases if bowel resection is required due to ischemia or pathology discovered intraoperatively
    49900Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)Used when additional intra-abdominal exploration is required before rectopexy
    49505Repair initial incisional or ventral hernia; reducibleIncluded when concurrent lower abdominal wall or incisional hernia repair is performed at same operative setting
    55700Radical retropubic prostatectomy, with or without nerve sparing (for male patients)Listed as possible concurrent pelvic surgery in male patients when clinically indicated

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    207L00000X
    2086S0122X
    213E00000X
    363L00000X
    364SP0810X
    2472D0500X
    2081P2900X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E03.8Other specified hypothyroidism
    E03.9Hypothyroidism, unspecified
    I10Essential (primary) hypertension
    K59.1Functional diarrhea
    K59.2Neurogenic bowel, not elsewhere classified
    K62.3Rectal prolapse
    K62.5Hemorrhage of anus and rectum
    K62.9Disease of anus and rectum, unspecified
    K64.0First degree hemorrhoids
    K64.1Second degree hemorrhoids

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-45500-ANORECTAL-STENOSIS-RELEASE-WITH-FLAP-REPAIR

    CPT 45500: Surgical Release of Anorectal Stenosis with Flap Repair

    CPT-45505-RECTAL-MUCOSA-EXCISION-AND-FLAP-REPAIR

    CPT 45505: Excision of Prolapsed Rectal Mucosa with Flap Repair

    CPT-45520-RECTAL-SCLEROTHERAPY-FOR-PROLAPSED-MUCOSA

    CPT 45520: Sclerotherapy for Prolapsed Rectal Mucosa

    CPT-45541-PERINEAL-RECTAL-PROLAPSE-REPAIR-MESH-SUTURES

    CPT 45541: Perineal Repair of Rectal Prolapse with Sutures and Mesh

    CPT-45550-RECTOPEXY-WITH-SIGMOID-RESECTION

    CPT 45550: Abdominal Repair of Rectal Prolapse with Sigmoid Resection

    CPT-45560-RECTOCELE-REPAIR-VAGINAL

    CPT 45560: Rectocele Repair, Vaginal

    CPT-45562-RECTAL-REPAIR-PRESACRAL-DRAINAGE

    CPT 45562: Exploration and Repair of Rectum with Presacral Drainage

    CPT-45563-RECTAL-INJURY-REPAIR-SIGMOID-COLOSTOMY

    CPT 45563: Exploratory Abdominal Surgery, Repair Rectal Injury and Sigmoid Colostomy

    CPT-45800-RECTOVESICAL-FISTULA-REPAIR-OPEN-ABDOMINAL

    CPT 45800: Repair of Rectovesical Fistula, Abdominal Approach

    CPT-45805-RECTOVESICAL-FISTULA-REPAIR-WITH-SIGMOID-COLOSTOMY

    CPT 45805: Rectovesical Fistula Repair with Sigmoid Colostomy

    Showing 1–10 of 12

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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