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CPT code 44604: Colon repair, single perforation2026 Medicare rate & RVUs

Reports suture repair of one perforation in the colon, such as a defect from injury, rupture, ulcer, or diverticulum.

CMS RVU26DEffective Oct 1, 2026109 payment localities983 Medicare services in 2024

Medicare pays $974.64 for 44604 nationally in a facility.

Medicare rate · 44604

Colon repair, single perforation

Office or facility?

Work RVUs
17.71
Total RVUs
29.18
Global days
090

National rate · 2026

$974.64

Facility setting, before claim adjustments.

See every locality for 44604 →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 44604 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 44604 covers

This code describes surgical suture repair of a single perforation in the large intestine. Typical situations include a colon injury or rupture, or a perforation associated with an ulcer or diverticulum. General and colorectal surgeons commonly perform the repair in an operating room, including during emergency abdominal surgery. The repair closes the colon defect rather than treating a stoma or fistula.

Select this code when the operative report identifies one perforation in the colon and documents its location, cause, and repair. Multiple perforations and small-intestine defects are coded differently. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 allowed; 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 44604 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

44604 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$882.68
AlaskaUnavailable$1,222.00
ArizonaUnavailable$946.65
ArkansasUnavailable$871.56
Atlanta, GAUnavailable$1,008.93
Austin, TXUnavailable$973.51
Bakersfield, CAUnavailable$953.20
Baltimore area, MDUnavailable$1,035.46
Beaumont, TXUnavailable$942.87
Brazoria, TXUnavailable$945.83

44604 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
44604 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 44604 rate is calculated

Each of 44604’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 · 44604

RVUs × geographic indexes × conversion factor

Office or facility?

Work17.71

17.71 RVUs× 1.000 GPCI

Practice expense7.20

7.20 RVUs× 1.000 GPCI

Malpractice4.27

4.27 RVUs× 1.000 GPCI

Adjusted RVUs

29.1800

Conversion factor

$33.4009

Medicare rate

$974.64

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

Payment rules and modifiers for 44604

44604 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44604

Colon repair, single perforation

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 · 44604

Colon repair, single perforation

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

44604 without 51 · national facility

$974.64

Colon repair, single perforation

44604-51 · Second procedure: 50%

$487.32

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

44604 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44604

    Colon repair, single perforation17.71 wRVU

    Not priced

  • 44605

    Colon repair, multiple perforations21.53 wRVU

    Not priced

  • 44602

    Small-bowel repair, single injury perforation24.1 wRVU

    Not priced

  • 44603

    Small bowel suture, each additional repair27.46 wRVU

    Not priced

How to choose

44605Colon repairMultiple perforations
Both codes describe suture repair of colon perforations; 44604 is for one perforation, while 44605 is for multiple perforations.
44602Small-bowel repairSingle injury perforation
44602 is for a single perforation in the small intestine. Choose 44604 when the repaired perforation is in the colon.
44603Small bowel sutureEach additional repair
44603 describes repair of multiple small-intestine perforations; 44604 describes repair of one colon perforation.

Codes related to 44604

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

Codes related to 44604
CodeHow it relatesNational office range
Same family
44605Colon repair, multiple perforationsColon suture repair code for multiple perforations.No office rate
44602Small-bowel repair, single injury perforationSuture repair of a single perforation in the small intestine.No office rate
44603Small bowel suture, each additional repairSuture repair of multiple perforations in the small intestine.No office rate

44604 billing questions

When should 44604 be chosen over 44605?

Use 44604 for repair of one colon perforation. For multiple colon perforations repaired in the same operative setting, consider 44605.

Can 44604 be used for a small-intestine perforation?

No. This code is for the colon; small-intestine suture repairs are reported with the corresponding small-intestine codes.

What operative documentation supports 44604?

Document that the defect is in the colon, that there is a single perforation, and the cause and repair performed.

How does the multiple-procedure reduction affect 44604?

When other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation.

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 44604PPRRVU2026_Oct_nonQPP.csv, line 5,428 (RVU26D)

Open CMS sourceHow we calculate rates

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