45119 Remove rectum with reservoir
Also known as: total proctectomy with pouch, IPAA, J-pouch surgery
Total proctectomy (complete removal of the rectum) with construction of a colonic pouch reservoir, typically performed for inflammatory bowel disease or familial adenomatous polyposis.
In Plain Language
removal of entire rectum with creation of pouch; colon surgery to create intestinal reservoir; rectum removal with bowel reconstruction
Clinical Context
Used for ulcerative colitis, familial adenomatous polyposis, or familial polyposis requiring complete rectal removal with continence restoration through ileal pouch-anal anastomosis.
RVU Breakdown
| Work RVU | 32.64 |
| Total RVU | 32.64 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 32.64, this code ranks in the 94th percentile among Surgery codes — 4.1x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 45119?
CPT 45119 (Remove rectum with reservoir) is a Surgery code. Total proctectomy (complete removal of the rectum) with construction of a colonic pouch reservoir, typically performed for inflammatory bowel disease or familial adenomatous polyposis.
What is the wRVU value for CPT 45119?
The work RVU for CPT 45119 is 32.64. This code is primarily used by Colorectal Surgery, General Surgery, Gastrointestinal Surgery. It has a 90-day global period.
When is CPT 45119 used?
Used for ulcerative colitis, familial adenomatous polyposis, or familial polyposis requiring complete rectal removal with continence restoration through ileal pouch-anal anastomosis.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.