CPT code 44604: Colon repair, single perforation2026 Medicare rate & RVUs in Maryland
Reports suture repair of one perforation in the colon, such as a defect from injury, rupture, ulcer, or diverticulum.
CMS doesn’t publish an office rate for 44604 in Maryland.
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 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 in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,035.46 |
| Rest of Maryland | Unavailable | $971.74 |
| Washington, DC area | Unavailable | $1,065.50 |
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
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
| 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 · 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.
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%).
44604 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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