45135 Excision of rectal prolapse
Also known as: perineal proctosigmoidectomy, Altemeier procedure, perineal prolapse repair
Excision of rectal prolapse by perineal approach (Altemeier procedure), removing prolapsed rectal tissue via circumferential excision through the perineum.
In Plain Language
buttock area prolapse surgery; perineal rectum repair; external prolapse removal
Clinical Context
Preferred for elderly or infirm patients with full-thickness rectal prolapse, offering reduced morbidity compared to abdominal approach despite higher recurrence.
RVU Breakdown
| Work RVU | 21.80 |
| Total RVU | 21.80 |
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 21.80, this code ranks in the 85th percentile among Surgery codes — 2.7x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 45135?
CPT 45135 (Excision of rectal prolapse) is a Surgery code. Excision of rectal prolapse by perineal approach (Altemeier procedure), removing prolapsed rectal tissue via circumferential excision through the perineum.
What is the wRVU value for CPT 45135?
The work RVU for CPT 45135 is 21.80. This code is primarily used by Colorectal Surgery, General Surgery, Pelvic Floor Surgery. It has a 90-day global period.
When is CPT 45135 used?
Preferred for elderly or infirm patients with full-thickness rectal prolapse, offering reduced morbidity compared to abdominal approach despite higher recurrence.
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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.