CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 45900 RVU and Medicare Payment (2026)
Reduction of rectal prolapse — 2.92 work RVU, about $211.43 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 2.92
- PE RVU (non-facility)
- 2.62
- PE RVU (facility)
- 2.62
- MP RVU
- 0.79
- Office payment
- $211.43
- Facility payment
- $211.43
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 45900 in a non-facility setting with national GPCI: (2.92 + 2.62 + 0.79) × $33.4009 ≈ $211.43. The same code in a facility setting pays about $211.43 because facility PE RVU (2.62) replaces office PE RVU.
What changes by locality
GPCI moves 45900 non-facility payment from $186.29 to $256.82 across CMS localities — from Arkansas to Nyc Suburbs/long Island. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 45900?
2.92. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 45900 in 2026?
About $211.43 non-facility ($211.43 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (2.92) and malpractice RVU stay fixed; only practice expense changes (2.62 office vs 2.62 facility). That is the entire office-vs-facility payment gap.