CPT code 44660: Bowel-bladder fistula repair, without bowel resection2026 Medicare rate & RVUs

Medicare pays $1,216.46 for 44660 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 44660 covers

This service treats an abnormal passage between the bowel and urinary bladder, often a colovesical fistula associated with diverticular disease. A colorectal or general surgeon typically operates in a hospital or other surgical facility, separating the involved organs and closing the fistula. A urologist may participate when the bladder portion requires additional operative attention. The code distinguishes repair without bowel resection from the related service that includes intestinal resection.

Report the code when the operative record supports closure of the bowel-bladder tract without resecting intestine; document the fistula’s location, operative steps, and whether bowel was removed. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Bilateral adjustment does not apply because modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; 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 44660 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

44660 rates by state

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

How the 44660 rate is calculated

Each of 44660’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.

Payment rules and modifiers for 44660

44660 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

44660 compared with similar codes

How to choose

44661Fistula repairWith bowel or bladder resection

Choose 44660 for fistula closure without intestinal resection. Consider 44661 when the operative service includes resection of intestine.

44650Fistula repairIntestinal fistula

This code addresses a bowel-bladder connection. Code 44650 is for a different intestinal fistula repair, so the documented destination of the tract matters.

44640Fistula repairBowel to skin

44640 concerns a bowel-to-skin fistula; 44660 is for a connection between bowel and bladder.

44604Colon repairSingle perforation

44604 describes suturing large intestine, not repair of a bowel-bladder fistula. Select based on the operation actually performed.

Codes related to 44660

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

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

Open CMS sourceHow we calculate rates