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CPT 45562: Exploratory Rectal Repair with Presacral Drainage

CPT code 45562 denotes an open surgical exploration and repair of rectal injury with drainage of presacral or presacral-adjacent abscess or fluid. This code captures procedures where the lower abdomen or perineal region is incised to identify and repair rectal defects and to evacuate collections anterior to the sacrum. Nationally, accurate use of this code is important for hospital billing, surgical casemix reporting, and quality monitoring of complex anorectal interventions.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of clinical context for 45562, typical settings of care, and the operational implications for hospital surgical services. Readers will find benchmarks for utilization and payment where available, coding guidance on procedure documentation essentials, and summaries of relevant policy updates affecting surgical billing for rectal repair and presacral drainage. The report also highlights common billing modifiers and situational considerations for inpatient versus outpatient coding. Data not available in the input are noted where applicable.

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Billing Code Overview

CPT code 45562 describes an open surgical procedure in which the provider makes an incision in the lower abdominal or perineal area to inspect the rectum for injury, repair any identified rectal wounds, and drain abscesses or collections in the presacral space or anterior to the sacrum. This procedure is typically categorized as an abdominal/perineal exploratory and rectal repair with presacral drainage.

Service type: Surgical — abdominal/perineal exploration and rectal repair

Typical site of service: Operating room or surgical suite; may occur in an inpatient or other acute care hospital setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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CPT 45562: Exploratory Rectal Repair with Presacral Drainage

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Billing Code Overview

Service type: Surgical — abdominal/perineal exploration and rectal repair

Typical site of service: Operating room or surgical suite; may occur in an inpatient or other acute care hospital setting

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 38-year-old patient presents to the emergency department after a pelvic fracture sustained in a motor vehicle collision with perineal pain, rectal bleeding, and tender presacral swelling on exam. The surgical team evaluates for possible rectal injury and presacral abscess. Imaging (CT pelvis) suggests a presacral fluid collection and concern for rectal wall disruption. The patient is taken to the operating room for an exploratory incision of the lower abdomen to inspect the rectum, identify and repair any rectal injury, and drain the presacral abscess or fluid collection. Intraoperative steps include lower midline or Pfannenstiel incision as indicated, exposure of the rectum, direct inspection and primary repair of any full-thickness rectal laceration, presacral space drainage with placement of drains, and irrigation. Postoperative care includes wound and drain management, antibiotics, tetanus status review, and monitoring for sepsis or fecal diversion needs. Typical providers include colorectal surgeons, general surgeons, or trauma surgeons performing this procedure in an operating room setting under general anesthesia. Typical place of service is an inpatient operating room or emergency surgery suite, with postoperative recovery on a surgical ward or intensive care unit as clinically indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work required is substantially greater than typically required for the procedure (extensive adhesiolysis, unexpected complexity).
`23`	Unusual anesthesia	Use when general anesthesia is required but would normally be avoided for this procedure due to patient condition.
`26`	Professional component	Use if a separately reportable professional interpretation or service component exists (rare for this operative procedure).
`50`	Bilateral procedure	Use if a bilateral approach or bilateral anatomic sites are involved and payor requires bilateral modifier (uncommon for presacral drainage).
`51`	Multiple procedures	Use when multiple distinct procedures are performed during the same operative session (e.g., rectal repair plus colostomy).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the procedure concurrently.
`66`	Surgical team	Use when a surgical team (multiple surgeons with assigned roles) performs the operation.
`73`	Discontinued outpatient procedure prior to anesthesia	Use if cancellation occurs before anesthesia administration in an outpatient setting.
`78`	Return to OR for related procedure during global period	Use when the patient returns to the operating room for a related procedure during the postoperative global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	(Not in provided list) Not listed — excluded.
`80`	Assistant surgeon	Use when an assistant surgeon provided significant intraoperative help.
`81`	Minimum assistant surgeon	Use when a minimal assistant presence is documented.

Taxonomy Code	Specialty	Notes
207T00000X	Colorectal Surgery	Primary specialty for rectal repair and presacral drainage procedures.
208000000X	General Surgery	Often performs exploratory laparotomy and rectal injury repair in trauma settings.
2080S0123X	Surgical Critical Care / Trauma Surgery	Manages complex trauma-related rectal injuries and presacral sepsis.
2084P0800X	Colon and Rectal Surgery (alternate taxonomy)	Practitioners focusing on anorectal surgical pathology and repairs.
207K00000X	Pediatric Surgery	When procedure is performed in pediatric patients (if applicable).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K63.1`	Perforation of intestine (nontraumatic)	Represents intestinal or rectal perforation requiring exploration and repair.
`K65.0`	Acute peritonitis	Indicates peritoneal contamination that may accompany rectal injury and abscess formation.
`K67`	Other disorders of peritoneum	Includes presacral or pelvic inflammatory collections necessitating drainage.
`S36.691A`	Laceration of rectum and anus, initial encounter	Trauma-related rectal laceration directly treated by this procedure.
`K61.9`	Abscess of anal and rectal regions, unspecified	Presacral or deep pelvic abscess requiring drainage and repair.
`T81.4XXA`	Infection following a procedure, initial encounter	Used if postoperative presacral infection is being addressed surgically.
`S37.829A`	Laceration of other and unspecified parts of the urinary bladder and urethra, initial encounter	Included when pelvic trauma causes multi-organ pelvic injury explored during the same operation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterectomy, resection of small intestine; single resection and anastomosis	May be performed if associated intestinal injury is found during exploration.
`44127`	Laparoscopy, surgical; ileocecectomy, with anastomosis	Minimally invasive bowel resection option if indicated concurrently.
`44605`	Repair of rectal injury; simple repair	Directly related—alternative specific code for simple rectal wall repairs.
`44615`	Rectal repair, complex, involving mucosal and full-thickness reconstruction	Use for more complex rectal repairs when extensive reconstruction is required.
`46040`	Excision of rectal lesion; transanal, with primary closure (partial list)	May be relevant for local rectal procedures accessed transanally.
`49560`	Drainage of infected or noninfected subcutaneous abscess; complicated or multiple	Related to drainage procedures of presacral or deep pelvic abscess if coded separately.

CPT 45500: 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: Injection of Sclerosant for Prolapsed Rectal Mucosa

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

CPT 45540: Abdominal Rectopexy for Rectal Prolapse

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

CPT 45541: Perineal Rectal Prolapse Repair with Mesh and Sutures

CPT-45550-RECTOPEXY-WITH-SIGMOID-RESECTION

CPT 45550: Open Rectopexy with Sigmoid Resection

CPT-45560-RECTOCELE-REPAIR-VAGINAL

CPT 45560: Rectocele Repair (Vaginal)

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

CPT 45563: Rectal Injury Repair with Sigmoid Colostomy

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

CPT 45800: Open Abdominal Repair of Rectovesical Fistula

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.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
`22`	Increased procedural services	Use when the work required is substantially greater than typically required for the procedure (extensive adhesiolysis, unexpected complexity).
`23`	Unusual anesthesia	Use when general anesthesia is required but would normally be avoided for this procedure due to patient condition.
`26`	Professional component	Use if a separately reportable professional interpretation or service component exists (rare for this operative procedure).
`50`	Bilateral procedure	Use if a bilateral approach or bilateral anatomic sites are involved and payor requires bilateral modifier (uncommon for presacral drainage).
`51`	Multiple procedures	Use when multiple distinct procedures are performed during the same operative session (e.g., rectal repair plus colostomy).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the procedure concurrently.
`66`	Surgical team	Use when a surgical team (multiple surgeons with assigned roles) performs the operation.
`73`	Discontinued outpatient procedure prior to anesthesia	Use if cancellation occurs before anesthesia administration in an outpatient setting.
`78`	Return to OR for related procedure during global period	Use when the patient returns to the operating room for a related procedure during the postoperative global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	(Not in provided list) Not listed — excluded.
`80`	Assistant surgeon	Use when an assistant surgeon provided significant intraoperative help.
`81`	Minimum assistant surgeon	Use when a minimal assistant presence is documented.

Taxonomy Code	Specialty	Notes
207T00000X	Colorectal Surgery	Primary specialty for rectal repair and presacral drainage procedures.
208000000X	General Surgery	Often performs exploratory laparotomy and rectal injury repair in trauma settings.
2080S0123X	Surgical Critical Care / Trauma Surgery	Manages complex trauma-related rectal injuries and presacral sepsis.
2084P0800X	Colon and Rectal Surgery (alternate taxonomy)	Practitioners focusing on anorectal surgical pathology and repairs.
207K00000X	Pediatric Surgery	When procedure is performed in pediatric patients (if applicable).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K63.1`	Perforation of intestine (nontraumatic)	Represents intestinal or rectal perforation requiring exploration and repair.
`K65.0`	Acute peritonitis	Indicates peritoneal contamination that may accompany rectal injury and abscess formation.
`K67`	Other disorders of peritoneum	Includes presacral or pelvic inflammatory collections necessitating drainage.
`S36.691A`	Laceration of rectum and anus, initial encounter	Trauma-related rectal laceration directly treated by this procedure.
`K61.9`	Abscess of anal and rectal regions, unspecified	Presacral or deep pelvic abscess requiring drainage and repair.
`T81.4XXA`	Infection following a procedure, initial encounter	Used if postoperative presacral infection is being addressed surgically.
`S37.829A`	Laceration of other and unspecified parts of the urinary bladder and urethra, initial encounter	Included when pelvic trauma causes multi-organ pelvic injury explored during the same operation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterectomy, resection of small intestine; single resection and anastomosis	May be performed if associated intestinal injury is found during exploration.
`44127`	Laparoscopy, surgical; ileocecectomy, with anastomosis	Minimally invasive bowel resection option if indicated concurrently.
`44605`	Repair of rectal injury; simple repair	Directly related—alternative specific code for simple rectal wall repairs.
`44615`	Rectal repair, complex, involving mucosal and full-thickness reconstruction	Use for more complex rectal repairs when extensive reconstruction is required.
`46040`	Excision of rectal lesion; transanal, with primary closure (partial list)	May be relevant for local rectal procedures accessed transanally.
`49560`	Drainage of infected or noninfected subcutaneous abscess; complicated or multiple	Related to drainage procedures of presacral or deep pelvic abscess if coded separately.

CPT 45500: 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: Injection of Sclerosant for Prolapsed Rectal Mucosa

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

CPT 45540: Abdominal Rectopexy for Rectal Prolapse

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

CPT 45541: Perineal Rectal Prolapse Repair with Mesh and Sutures

CPT-45550-RECTOPEXY-WITH-SIGMOID-RESECTION

CPT 45550: Open Rectopexy with Sigmoid Resection

CPT-45560-RECTOCELE-REPAIR-VAGINAL

CPT 45560: Rectocele Repair (Vaginal)

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

CPT 45563: Rectal Injury Repair with Sigmoid Colostomy

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

CPT 45800: Open Abdominal Repair of Rectovesical Fistula

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.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 45562: Exploratory Rectal Repair with Presacral Drainage

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Billing Code Overview

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CPT 45562: Exploratory Rectal Repair with Presacral Drainage

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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

CPT 45562: Exploratory Rectal Repair with Presacral Drainage

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Billing Code Overview

CPT 45562: Exploratory Rectal Repair with Presacral Drainage

Sign up for cpt 45562 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical scenario and services does CPT 45562 describe?

Which modifiers are commonly relevant when billing CPT 45562 and when should they be considered?

Which provider specialties and taxonomy codes are most commonly associated with CPT 45562?

What related CPT codes should be reviewed when 45562 is performed with additional procedures?

Which payers are referenced for CPT 45562 and why is accurate coding important?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical scenario and services does CPT 45562 describe?

Which modifiers are commonly relevant when billing CPT 45562 and when should they be considered?

Which provider specialties and taxonomy codes are most commonly associated with CPT 45562?

What related CPT codes should be reviewed when 45562 is performed with additional procedures?

Which payers are referenced for CPT 45562 and why is accurate coding important?

References