FeeBase
Log inGet started
Menu

CPT code 44187: Laparoscopic ostomy, ileum or jejunum, non-tube2026 Medicare rate & RVUs

Reports laparoscopic creation of a non-tube ileostomy or jejunostomy, typically to divert intestinal contents through a surgically created abdominal opening.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.6K Medicare services in 2024

Medicare pays $1,024.74 for 44187 nationally in a facility.

Medicare rate · 44187

Laparoscopic ostomy, ileum or jejunum, non-tube

Office or facility?

Work RVUs
16.97
Total RVUs
30.68
Global days
090

National rate · 2026

$1,024.74

Facility setting, before claim adjustments.

See every locality for 44187 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 44187 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 44187 covers

The surgeon uses a laparoscopic approach to bring a segment of ileum or jejunum to the abdominal wall and create a non-tube stoma. This may provide intestinal diversion when the downstream bowel needs to be bypassed, such as to protect a distal anastomosis or manage obstruction. The code describes an ostomy, not placement of a feeding or decompression tube. It is generally performed by a general or colorectal surgeon in a hospital operating room.

Report the code when the operative documentation supports laparoscopic creation of a non-tube ileostomy or jejunostomy; document the bowel segment, approach, and stoma created. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 44187 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

44187 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$932.41
AlaskaUnavailable$1,279.54
ArizonaUnavailable$997.71
ArkansasUnavailable$921.11
Atlanta, GAUnavailable$1,054.78
Austin, TXUnavailable$1,032.90
Bakersfield, CAUnavailable$1,024.16
Baltimore area, MDUnavailable$1,085.86
Beaumont, TXUnavailable$985.68
Brazoria, TXUnavailable$1,001.19

44187 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
44187 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 44187 rate is calculated

Each of 44187’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 44187

RVUs × geographic indexes × conversion factor

Office or facility?

Work16.97

16.97 RVUs× 1.000 GPCI

Practice expense10.31

10.31 RVUs× 1.000 GPCI

Malpractice3.40

3.40 RVUs× 1.000 GPCI

Adjusted RVUs

30.6800

Conversion factor

$33.4009

Medicare rate

$1,024.74

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 44187

44187 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44187

Laparoscopic ostomy, ileum or jejunum, non-tube

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 44187

Laparoscopic ostomy, ileum or jejunum, non-tube

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

44187 without 51 · national facility

$1,024.74

Laparoscopic ostomy, ileum or jejunum, non-tube

44187-51 · Second procedure: 50%

$512.37

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

44187 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44187

    Laparoscopic ostomy, ileum or jejunum, non-tube16.97 wRVU

    Not priced

  • 44186

    Jejunostomy, laparoscopic feeding access10.12 wRVU

    Not priced

  • 44188

    Colostomy, laparoscopic approach18.87 wRVU

    Not priced

  • 44310

    Small-bowel stoma, non-tube creation17.15 wRVU

    Not priced

How to choose

44186JejunostomyLaparoscopic feeding access
Choose 44186 for laparoscopic jejunostomy with a tube, commonly for feeding or decompression. Choose 44187 for a non-tube ileostomy or jejunostomy.
44188ColostomyLaparoscopic approach
44188 creates a laparoscopic colostomy or skin-level cecostomy; 44187 creates an ileal or jejunal stoma.
44310Small-bowel stomaNon-tube creation
44310 describes open creation of a non-tube ileostomy or jejunostomy. Use 44187 when the documented approach is laparoscopic.

Codes related to 44187

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 44187
CodeHow it relatesNational office range
Same family
44186Jejunostomy, laparoscopic feeding accessLaparoscopic jejunostomy with a tube, rather than the non-tube ostomy reported here.No office rate
44188Colostomy, laparoscopic approachLaparoscopic creation of a colostomy or skin-level cecostomy.No office rate
Used instead
44310Small-bowel stoma, non-tube creationOpen non-tube ileostomy or jejunostomy for the same general diversion need.No office rate

44187 billing questions

How is this different from 44186?

44187 is for a non-tube ileostomy or jejunostomy. 44186 describes laparoscopic jejunostomy with a tube, such as for feeding or decompression.

When should 44188 be reported instead?

Use 44188 when the laparoscopically created ostomy is a colostomy or skin-level cecostomy. Code 44187 is for an ileal or jejunal stoma.

Can 44187 be used for an open procedure?

No. This code describes laparoscopic ostomy creation; 44310 is the open non-tube ileostomy or jejunostomy alternative.

Is modifier 50 appropriate for two ostomies?

CMS identifies bilateral adjustment as inappropriate for this code. Modifier 50 should not be used to represent bilateral performance.

What documentation supports reporting 44187?

The operative report should establish the laparoscopic approach, whether ileum or jejunum was used, and creation of a non-tube stoma. It should distinguish the service from tube jejunostomy.

How does the 90-day global period affect follow-up?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 44187PPRRVU2026_Oct_nonQPP.csv, line 5,364 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 44187 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 44187 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist