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Billing code 44156: ColectomyMedicare rate & RVUs

Reports open removal of the entire colon and rectum with creation of a continent ileostomy, typically for extensive colonic disease requiring this reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $2,147.68 for 44156 nationally in a facility.

Medicare rate · 44156

Colectomy

Swap in your local Medicare rate.

Work RVUs
36.48
Total RVUs
64.30
Global days
090

National rate · 2026

$2,147.68

Facility setting, before claim adjustments.

See every locality for 44156 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 44156 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 44156 covers

A colorectal surgeon removes the entire colon and rectum through an abdominal operation and forms a continent ileostomy from the small bowel. The internal reservoir connects to a catheterizable abdominal stoma, allowing the patient to empty it by catheter rather than use a conventional external ileostomy appliance. This reconstruction may be performed for extensive disease such as ulcerative colitis or familial adenomatous polyposis when proctectomy and a continent diversion are planned.

Report this code when the operative record supports total colectomy, proctectomy, and creation of the continent ileostomy; a conventional end ileostomy or ileoanal reconstruction represents a different operation. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. 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 44156 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

44156 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,930.48
Alaska*Unavailable$2,649.23
ArizonaUnavailable$2,081.92
ArkansasUnavailable$1,904.17
AtlantaUnavailable$2,226.69
AustinUnavailable$2,147.77
BakersfieldUnavailable$2,100.79
Baltimore/Surr. CntysUnavailable$2,288.63
BeaumontUnavailable$2,070.26
BrazoriaUnavailable$2,080.07

44156 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
44156 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 44156 rate is calculated

Each of 44156’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 · 44156

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 36.48Practice expense 18.03Malpractice 9.79

64.3000 adjusted RVUs×$33.4009 conversion factor=$2,147.68

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 44156

44156 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44156

Colectomy

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 · 44156

Colectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

44156 without 51 · national facility

$2,147.68

Colectomy

44156-51 · Second procedure: 50%

$1,073.84

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

44156 compared with similar codes

Compare codes

44156 vs 44155 vs 44151 vs 44157 vs 44158: national Medicare rates

Swap in your local Medicare rate.

  • 44156
    Colectomy · 36.48 wRVU
    —
  • 44155
    Colectomy · 33.56 wRVU
    —
  • 44151
    Total colectomy · 34.05 wRVU
    —
  • 44157
    Proctocolectomy · 34.81 wRVU
    —
  • 44158
    Colectomy · 35.78 wRVU
    —

How to choose

44155Colectomy
Choose 44156 for a continent, catheterizable ileostomy after total colectomy and proctectomy; 44155 describes the conventional ileostomy reconstruction.
44151Total colectomy
Both describe a continent ileostomy with total colectomy, but 44151 does not include proctectomy. The operative report must establish whether the rectum was removed.
44157Proctocolectomy
44157 describes ileoanal anastomosis after total colectomy and proctectomy. Use 44156 when the reconstruction is a continent ileostomy through an abdominal stoma.
44158Colectomy
44158 includes an ileal reservoir for ileoanal reconstruction; 44156 creates a continent abdominal ileostomy rather than an ileoanal connection.

Codes related to 44156

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

Codes related to 44156
CodeHow it relatesNational office range
Same family
44151Total colectomyContinent ileostomy with total colectomy, but without the proctectomy included in 44156.No office rate
44155ColectomyTotal colectomy with proctectomy and conventional ileostomy rather than a continent reservoir.No office rate
44157ProctocolectomyTotal colectomy with proctectomy and ileoanal anastomosis instead of a continent abdominal ileostomy.No office rate
44158ColectomyTotal colectomy with proctectomy and ileoanal reconstruction using an ileal reservoir.No office rate
44150Total colectomyTotal colectomy without proctectomy, with ileostomy or ileoproctostomy.No office rate

44156 billing questions

How does this differ from 44155?

Both include total colectomy and proctectomy. Code 44156 includes creation of a continent ileostomy; 44155 describes a conventional ileostomy.

When is 44151 a closer match?

44151 describes total colectomy with a continent ileostomy without proctectomy. Use 44156 when the rectum is also removed.

Does this code include the continent ileostomy?

Yes. Creation of the continent ileostomy is part of the operation represented by this code, alongside total colectomy and proctectomy.

How does 44156 differ from 44157 or 44158?

44157 and 44158 describe ileoanal reconstruction after proctectomy, with 44158 including creation of an ileal reservoir. Code 44156 instead creates a continent abdominal ileostomy.

What documentation supports reporting 44156?

The operative report should establish removal of the entire colon and rectum and formation of a continent, catheterizable ileostomy. It should distinguish this reconstruction from a conventional ileostomy or ileoanal connection.

How are other same-session procedures and surgical assistants handled?

Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 44156PPRRVU2026_Oct_nonQPP.csv, line 5,358 (RVU26D)

Open CMS sourceHow we calculate rates

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