CPT code 44187: Laparoscopic ostomy, ileum or jejunum, non-tube2026 Medicare rate & RVUs in Pennsylvania
Reports laparoscopic creation of a non-tube ileostomy or jejunostomy, typically to divert intestinal contents through a surgically created abdominal opening.
CMS doesn’t publish an office rate for 44187 in Pennsylvania.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | Unavailable | $1,070.98 |
| Rest of Pennsylvania | Unavailable | $990.26 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share 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.
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%).
44187 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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