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    v1.0.30
    OpenPayerBilling CodesRepair Procedures on the RectumCPT cpt-45550-rectopexy-with-sigmoid-resection
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    CPT 45550: Abdominal Repair of Rectal Prolapse with Sigmoid Resection

    Medicare pays $1371 on average nationally for this procedure.

    CPT code 45550 describes an open abdominal procedure for repair of rectal prolapse with suture and mesh reinforcement combined with resection of the redundant sigmoid colon; this is a major abdominal/colorectal surgery typically performed in an operating room setting under general anesthesia and involves both pelvic floor reconstruction and bowel resection as the service type.

    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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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old female presents with symptomatic full‑thickness rectal prolapse characterized by fecal urgency, mucous discharge, and partial obstruction. Conservative measures including pelvic floor therapy and stool regimen failed. Preoperative evaluation includes colonoscopy to exclude mucosal lesions, cross‑sectional imaging if indicated, and routine preoperative labs and anesthesia assessment. The surgeon plans an open abdominal rectopexy with sigmoid resection to correct the prolapse, fix the rectum to the presacral fascia with sutures and prosthetic mesh, and perform a sigmoid colectomy to remove redundant colon and reduce recurrence risk. The procedure is performed in an inpatient operating room under general anesthesia with postoperative monitoring on a surgical ward; typical recovery includes bowel function monitoring, pain control, deep venous thrombosis prophylaxis, early ambulation, and discharge planning in 3–5 days if uncomplicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    44140Colectomy, partial; with anastomosisMay be reported when a more extensive sigmoid colectomy with primary anastomosis is performed alongside rectopexy when operative details meet code definition
    45330Sigmoidoscopy, flexible; diagnostic, with or without collection of specimenPerformed preoperatively or intraoperatively to assess mucosa and rule out intraluminal pathology
    44204Laparoscopy, surgical; colectomy, partial, with anastomosisUsed when the sigmoid resection and rectopexy are performed laparoscopically rather than via open abdominal incision
    43770Colostomy or ileostomy, simple fecal diversionMay be performed as a staged or adjunct procedure when diversion is required due to contamination or anastomotic concern
    99223Initial hospital care, typically 70 minutes or moreRepresents inpatient admission evaluation and management for a complex surgical patient pre- or postoperatively
    49560Closure of stoma, colostomy or ileostomy; electiveMay be used in the future if a temporary diversion is reversed after recovery

    Related Modifiers

    9 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…
    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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due 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…
    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
    207R00000X
    208800000X
    2080P0205X
    207P00000X
    324500000X
    246ZG0701X
    251300000X
    320700000X

    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-45540-ABDOMINAL-RECTOPEXY-RECTAL-PROLAPSE-MESH-SUTURE

    CPT 45540: Abdominal Repair of Rectal Prolapse with Suture and Mesh

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

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

    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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