CPT code 44316: Continent ileostomy, reservoir pouch creation2026 Medicare rate & RVUs in Texas
Reports surgical construction of a continent ileal reservoir, such as a Kock pouch, that stores intestinal contents and empties through a catheterized stoma.
CMS doesn’t publish an office rate for 44316 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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What 44316 covers
This operation creates an internal reservoir from small bowel and forms a continent outlet at the abdominal wall. The patient empties the pouch by passing a catheter through the stoma rather than collecting output continuously in an external ostomy appliance. A colorectal or general surgeon may perform it for a patient requiring ileal diversion, including selected patients after colectomy for ulcerative colitis or familial adenomatous polyposis. The operative report should identify the reservoir and continent outlet being constructed.
Report 44316 when the continent ileostomy construction is the service represented, rather than a conventional ileostomy. When the surgeon performs it as part of a comprehensive colectomy that includes a continent ileostomy, use the applicable colectomy code instead of separately reporting the pouch construction. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For other procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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 44316 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 | $1,322.75 |
| Beaumont, TX | Unavailable | $1,278.20 |
| Brazoria, TX | Unavailable | $1,282.07 |
| Dallas, TX | Unavailable | $1,300.64 |
| Fort Worth, TX | Unavailable | $1,299.81 |
| Galveston, TX | Unavailable | $1,292.65 |
| Houston, TX | Unavailable | $1,405.40 |
| Rest of Texas | Unavailable | $1,286.52 |
How the 44316 rate is calculated
Each of 44316’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 · 44316
RVUs × geographic indexes × conversion factor
Work23.00
23.00 RVUs× 1.000 GPCI
Practice expense10.49
10.49 RVUs× 1.000 GPCI
Malpractice6.16
6.16 RVUs× 1.000 GPCI
Adjusted RVUs
39.6500
Conversion factor
$33.4009
Medicare rate
$1,324.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44316
44316 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44316
Continent ileostomy, reservoir pouch creation
| 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 · 44316
Continent ileostomy, reservoir pouch creation
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
44316 without 51 · national facility
$1,324.35
Continent ileostomy, reservoir pouch creation
44316-51 · Second procedure: 50%
$662.18
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%).
44316 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 44310Small-bowel stomaNon-tube creation
- Use 44316 for construction of a continent reservoir and catheterized outlet; 44310 describes a conventional ileostomy or jejunostomy.
- 44151Total colectomyContinent ileostomy
- 44151 includes continent ileostomy creation with total abdominal colectomy without proctectomy. Use 44316 when reporting the pouch construction itself rather than that combined colectomy service.
- 44156ColectomyProctectomy, continent ileostomy
- 44156 includes continent ileostomy creation with total abdominal colectomy and proctectomy. It represents the broader combined operation, not pouch construction alone.
- 44312Ileostomy revisionSimple revision
- 44312 describes revision of an existing ileostomy; 44316 creates a continent ileal reservoir.
44316 billing questions
How does 44316 differ from 44310?
44316 creates an internal reservoir with a continent catheterized outlet. 44310 describes a conventional ileostomy or jejunostomy rather than this pouch construction.
Can 44316 be reported with a colectomy code?
When the colectomy code includes creation of a continent ileostomy, report the applicable comprehensive colectomy code rather than separately reporting 44316 for the included pouch construction.
Does modifier 50 apply?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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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