CPT code 44661: Fistula repair, with bowel or bladder resection2026 Medicare rate & RVUs

Medicare pays $1,414.19 for 44661 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 44661 covers

This service treats an abnormal connection between the intestine and bladder when repair requires removal of involved bowel or bladder tissue. A colorectal or general surgeon commonly performs the intestinal portion, sometimes with a urologist participating in bladder repair. Typical cases include a colovesical fistula associated with diverticular disease, inflammatory bowel disease, or a tumor. The operation may involve separating the organs, removing the diseased segment, and repairing the remaining tissue.

Select this code when the operative report documents fistula repair with resection of intestine, bladder, or both; use the non-resection sibling when repair is completed without either resection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; 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 44661 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

44661 rates by state

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

How the 44661 rate is calculated

Each of 44661’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 44661

44661 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

44661 compared with similar codes

How to choose

44660Bowel-bladder fistula repairWithout bowel resection

Both codes address a bowel-bladder fistula. Choose 44661 when the repair includes resection of intestine, bladder tissue, or both; choose 44660 when it does not.

44650Fistula repairIntestinal fistula

This code is for a bowel fistula repair without the bowel-to-bladder connection that defines 44661.

44640Fistula repairBowel to skin

This code addresses a bowel-to-skin fistula. Use 44661 for a tract connecting bowel and bladder when the repair includes resection.

Codes related to 44661

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