Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesRepair Procedures on the RectumCPT cpt-45805-rectovesical-fistula-repair-with-sigmoid-colostomy
    Ask Trek AI about this page

    CPT 45805: Rectovesical Fistula Repair with Sigmoid Colostomy

    Medicare pays $1405 on average nationally for this procedure.

    CPT code 45805 describes an open abdominal surgical procedure to close a rectovesical fistula (an abnormal connection between the rectum and urinary bladder) combined with creation of a sigmoid colostomy to divert fecal flow and allow the fistula repair time to heal; service type: fistula repair with temporary colostomy, typical site of service: inpatient or operating room in a hospital.

    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.

    Customize your policy alerts

    Sign up for cpt 45805 policy alerts

    Get alerted when payer policies referencing 45805 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a middle-aged to older male who develops a rectovesical fistula, commonly after pelvic surgery, severe diverticulitis, radiation injury, Crohn disease, or malignancy involving the rectum or bladder. The patient presents with recurrent urinary tract infections, fecaluria (passage of fecal material in the urine), pneumaturia (air in the urine), suprapubic pain, and urinary frequency. Diagnostic workup includes pelvic imaging (CT or MRI), cystoscopy to visualize the bladder side of the fistula, and colonoscopy or sigmoidoscopy to evaluate the rectal mucosa.

    Surgical workflow for 45805 typically involves general or colorectal surgery teams in an inpatient operating room under general anesthesia. The operation includes an abdominal incision to identify and close the rectovesical fistula with layered repair of the bladder and rectum as appropriate, followed by formation of a sigmoid colostomy brought to the abdominal wall to divert fecal stream and protect the repair. Intraoperative steps often include cystotomy or cystoscopy as needed, mobilization of the sigmoid colon, creation of a stoma, and placement of appropriate drains. Postoperative care includes inpatient monitoring for infection, urine and stoma output assessment, wound care, antibiotics, and urology/colorectal follow-up. Elective timing may be delayed until infection/inflammation is controlled; urgent repair may occur for sepsis or uncontrolled fistula complications.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    44187Laparoscopy, surgical, enterolysis (freeing intestinal adhesion) (separate procedure)May be performed prior to or during 45805 if extensive adhesions are encountered during abdominal access.
    44615Excision of rectal tumor, partial; transabdominal approachPerformed when concomitant rectal pathology requires partial rectal resection in the same operative setting.
    51702Irrigation of bladder, simple (e.g., by catheter)Postoperative bladder irrigation may be used in management after bladder repair; performed as a separate bedside service.
    44143Colectomy, partial; with colostomy or ileostomyIf a larger bowel resection is required in addition to colostomy, this colectomy code may be billed in the same episode.
    49900Exploratory laparotomy, exploratory celiotomy (separate procedure)When an extensive abdominal exploration is required prior to definitive fistula repair, an exploratory laparotomy may be coded alongside or as the primary abdominal access code.

    Related Modifiers

    12 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…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    208D00000X
    363L00000X
    261QR0200X
    183700000X
    103TF0000X
    3336L0003X
    170100000X

    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-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

    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.
    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.