How Much Does Excision of Rectal Prolapse Cost?
Also known as: Excision of rectal prolapse (CPT 45130)
Repair of a rectal prolapse.
The total estimated cost of Excision of Rectal Prolapse (CPT 45130) is $3,376 to $6,330, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $1,005.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Excision of Rectal Prolapse
What you need to know before your appointment
What to Expect
Under anesthesia, the surgeon corrects a rectal prolapse (rectum protruding through the anus) using either an abdominal or perineal approach.
How Long Does It Take?
1-2 hours
Common Reasons Doctors Order This
Rectal prolapse causing discomfort, bleeding, or incontinence
How to Prepare
Bowel preparation before surgery. Avoid straining after. High-fiber diet and adequate hydration help prevent recurrence.
Procedures Commonly Done Together
These procedures are frequently performed alongside Excision of rectal prolapse
How to Reduce Your Cost for Excision of rectal prolapse
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (30.08) x CF ($33.40) = $1,005
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Excision of rectal prolapse cost?
The Medicare facility rate for Excision of rectal prolapse is $1,005. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Excision of rectal prolapse cost without insurance?
Without insurance, the cost of Excision of rectal prolapse can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Excision of rectal prolapse?
Most commercial health insurance plans and Medicare cover Excision of rectal prolapse when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.