45121 Removal of rectum and colon
Also known as: total colectomy with proctectomy, total abdominal colectomy and proctectomy, TACE
Proctocolectomy (removal of both rectum and colon) with or without ileostomy, used primarily for colorectal disease requiring total colonic and rectal resection.
In Plain Language
removal of entire colon and rectum; complete large bowel removal; colon and rectum removal
Clinical Context
Indicated for familial adenomatous polyposis, ulcerative colitis with pan-colonic involvement, or colorectal cancer with extensive colon involvement.
RVU Breakdown
| Work RVU | 28.35 |
| Total RVU | 28.35 |
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 28.35, this code ranks in the 91st percentile among Surgery codes — 3.5x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 45121?
CPT 45121 (Removal of rectum and colon) is a Surgery code. Proctocolectomy (removal of both rectum and colon) with or without ileostomy, used primarily for colorectal disease requiring total colonic and rectal resection.
What is the wRVU value for CPT 45121?
The work RVU for CPT 45121 is 28.35. This code is primarily used by Colorectal Surgery, General Surgery, Gastrointestinal Surgery. It has a 90-day global period.
When is CPT 45121 used?
Indicated for familial adenomatous polyposis, ulcerative colitis with pan-colonic involvement, or colorectal cancer with extensive colon involvement.
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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.