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CPT code 44188: Colostomy, laparoscopic approach2026 Medicare rate & RVUs

Report laparoscopic creation of a colonic stoma to divert intestinal contents, such as for obstruction, perforation, or protection of distal bowel.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.4K Medicare services in 2024

Medicare pays $1,139.64 for 44188 nationally in a facility.

Medicare rate · 44188

Colostomy, laparoscopic approach

Office or facility?

Work RVUs
18.87
Total RVUs
34.12
Global days
090

National rate · 2026

$1,139.64

Facility setting, before claim adjustments.

See every locality for 44188 →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 44188 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 44188 covers

The surgeon uses laparoscopic access to bring a portion of the colon to the abdominal wall and form a stoma. Colorectal and general surgeons commonly perform this operation in a hospital operating room to divert stool around distal obstruction, injury, inflammation, or a healing colorectal repair. The stoma may be intended as temporary diversion or long-term fecal diversion; the code identifies colonic rather than small-bowel ostomy creation.

Select 44188 when laparoscopic colostomy creation is the service performed, rather than a more extensive bowel-resection procedure that includes ostomy construction. The operative report should identify the laparoscopic approach, the colonic stoma created, and the clinical reason for diversion. Related preoperative care on the day before surgery and 90 days of postoperative care are included in the 90-day global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; 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 44188 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

44188 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,032.52
AlaskaUnavailable$1,415.61
ArizonaUnavailable$1,107.96
ArkansasUnavailable$1,019.45
Atlanta, GAUnavailable$1,175.69
Austin, TXUnavailable$1,146.26
Bakersfield, CAUnavailable$1,132.03
Baltimore area, MDUnavailable$1,209.97
Beaumont, TXUnavailable$1,096.47
Brazoria, TXUnavailable$1,110.43

44188 rates by state

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

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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
44188 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 44188 rate is calculated

Each of 44188’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 · 44188

RVUs × geographic indexes × conversion factor

Office or facility?

Work18.87

18.87 RVUs× 1.000 GPCI

Practice expense11.04

11.04 RVUs× 1.000 GPCI

Malpractice4.21

4.21 RVUs× 1.000 GPCI

Adjusted RVUs

34.1200

Conversion factor

$33.4009

Medicare rate

$1,139.64

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

Payment rules and modifiers for 44188

44188 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44188

Colostomy, laparoscopic approach

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 · 44188

Colostomy, laparoscopic approach

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

44188 without 51 · national facility

$1,139.64

Colostomy, laparoscopic approach

44188-51 · Second procedure: 50%

$569.82

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

44188 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44188

    Colostomy, laparoscopic approach18.87 wRVU

    Not priced

  • 44187

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

    Not priced

  • 44320

    Colostomy, open creation19.41 wRVU

    Not priced

  • 44206

    Partial colectomy, end colostomy, closed distal segment29.05 wRVU

    Not priced

How to choose

44187Laparoscopic ostomyIleum or jejunum, non-tube
Use 44187 for laparoscopic ileostomy or jejunostomy creation; 44188 creates a colonic stoma.
44320ColostomyOpen creation
44320 describes open colostomy creation. Choose 44188 when the stoma is created laparoscopically.
44206Partial colectomyEnd colostomy, closed distal segment
44206 includes laparoscopic partial colectomy with end colostomy. It is the more appropriate service when that bowel resection and diversion are performed together.

Codes related to 44188

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

Codes related to 44188
CodeHow it relatesNational office range
Used instead
44320Colostomy, open creationOpen colostomy creation for a comparable diversion performed without the laparoscopic approach.No office rate
44206Partial colectomy, end colostomy, closed distal segmentLaparoscopic partial colectomy with end colostomy when bowel resection and diversion are performed.No office rate
Same family
44187Laparoscopic ostomy, ileum or jejunum, non-tubeLaparoscopic ostomy creation for ileum or jejunum rather than colon.No office rate
44186Jejunostomy, laparoscopic feeding accessLaparoscopic jejunostomy creation, a small-bowel ostomy rather than a colostomy.No office rate

44188 billing questions

How does 44188 differ from a laparoscopic ileostomy?

44188 is for creating a colonic stoma. Use 44187 for laparoscopic ileostomy or jejunostomy creation.

Can 44188 be reported separately with a colectomy?

When a colectomy code describes the resection and associated ostomy construction, report that comprehensive procedure rather than separately reporting 44188 for the stoma.

What is the difference between 44188 and 44320?

Both describe colostomy creation, but 44188 is laparoscopic and 44320 is the open approach.

What documentation supports 44188?

The operative report should establish laparoscopic access, creation of a colonic stoma, and the indication for diversion. It should also make clear whether bowel resection was part of the operation.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be available for 44188. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

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

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 44188PPRRVU2026_Oct_nonQPP.csv, line 5,365 (RVU26D)

Open CMS sourceHow we calculate rates

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