CPT code 44212: Proctocolectomy, ileoanal pouch with loop ileostomy2026 Medicare rate & RVUs in Texas
Reports laparoscopic removal of the colon and rectum with ileal pouch construction, ileoanal connection, and a diverting loop ileostomy.
CMS doesn’t publish an office rate for 44212 in Texas.
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 44212 covers
A colorectal surgeon performs this operation laparoscopically to remove the entire colon and rectum, construct a reservoir from the ileum, connect it to the anus, and create a temporary loop ileostomy to divert stool. It is commonly performed for conditions such as ulcerative colitis or familial adenomatous polyposis when removal of the colon and rectum with an ileal pouch is planned. The service is typically performed in a hospital operating room.
Select this code when the operative report supports the laparoscopic approach, total colon and rectum removal, ileal pouch reconstruction, and loop ileostomy. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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 44212 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,872.45 |
| Beaumont, TX | Unavailable | $1,799.70 |
| Brazoria, TX | Unavailable | $1,822.06 |
| Dallas, TX | Unavailable | $1,841.55 |
| Fort Worth, TX | Unavailable | $1,838.81 |
| Galveston, TX | Unavailable | $1,832.78 |
| Houston, TX | Unavailable | $1,942.97 |
| Rest of Texas | Unavailable | $1,815.32 |
How the 44212 rate is calculated
Each of 44212’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 · 44212
RVUs × geographic indexes × conversion factor
Work33.72
33.72 RVUs× 1.000 GPCI
Practice expense16.01
16.01 RVUs× 1.000 GPCI
Malpractice6.02
6.02 RVUs× 1.000 GPCI
Adjusted RVUs
55.7500
Conversion factor
$33.4009
Medicare rate
$1,862.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44212
44212 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44212
Proctocolectomy, ileoanal pouch with loop ileostomy
| 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 · 44212
Proctocolectomy, ileoanal pouch with loop ileostomy
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
44212 without 51 · national facility
$1,862.10
Proctocolectomy, ileoanal pouch with loop ileostomy
44212-51 · Second procedure: 50%
$931.05
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%).
44212 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44210Total colectomyLaparoscopic, rectum retained
- 44210 describes total colectomy without proctectomy. This code includes removal of the rectum and ileal pouch reconstruction.
- 44211ProctocolectomyIleoanal pouch reconstruction
- 44211 includes total colectomy and proctectomy with ileostomy, but not the ileal pouch and ileoanal connection described here.
- 44204Partial colectomyLaparoscopic with anastomosis
- 44204 is for laparoscopic partial colectomy, not removal of the entire colon and rectum with pouch reconstruction.
44212 billing questions
How does this differ from a total proctocolectomy without a pouch?
This code describes ileal pouch construction with an ileoanal connection and diverting loop ileostomy. Use a different code when the operative reconstruction does not include those elements.
Is the ileal pouch separately reported?
The pouch construction is part of this operation when performed as described. The operative report should document the reconstruction and ileoanal connection.
What documentation supports reporting this code?
Document the laparoscopic approach, removal of the entire colon and rectum, ileal reservoir construction, ileoanal connection, and loop ileostomy.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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