45120 Removal of rectum
Also known as: total proctectomy, Miles operation, abdominoperineal resection variant
Total proctectomy (complete removal of the rectum) without pouch construction or anastomosis, typically requiring permanent colostomy.
In Plain Language
complete rectum removal; surgical removal of entire rectum; rectum extraction
Clinical Context
Performed for rectal cancer, severe inflammatory bowel disease, or familial polyposis when sphincter preservation is not possible or desired.
RVU Breakdown
| Work RVU | 25.74 |
| Total RVU | 25.74 |
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 25.74, this code ranks in the 89th percentile among Surgery codes — 3.2x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 45120?
CPT 45120 (Removal of rectum) is a Surgery code. Total proctectomy (complete removal of the rectum) without pouch construction or anastomosis, typically requiring permanent colostomy.
What is the wRVU value for CPT 45120?
The work RVU for CPT 45120 is 25.74. This code is primarily used by Colorectal Surgery, General Surgery, Oncologic Surgery. It has a 90-day global period.
When is CPT 45120 used?
Performed for rectal cancer, severe inflammatory bowel disease, or familial polyposis when sphincter preservation is not possible or desired.
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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.