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CPT code 44211: Proctocolectomy2026 Medicare rate & RVUs

Reports laparoscopic removal of the colon and rectum with ileal pouch construction and connection to the anus, with a diverting loop ileostomy when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities31 Medicare services in 2024

Medicare pays $1,927.23 for 44211 nationally in a facility.

Medicare rate · 44211

Proctocolectomy

Work RVUs
36.15
Total RVUs
57.70
Global days
090

National rate · 2026

$1,927.23

Facility setting, before claim adjustments.

See every locality for 44211 →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 44211 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 44211 covers

This laparoscopic restorative proctocolectomy removes the colon and rectum, forms an ileal reservoir, and connects it to the anus. Colorectal surgeons commonly perform it in an operating room for ulcerative colitis or familial adenomatous polyposis when ileoanal reconstruction is planned. A diverting loop ileostomy may be created as part of the operation.

Report 44211 when the completed procedure includes total colectomy with proctectomy, ileal pouch construction, and ileoanal anastomosis; the loop ileostomy, when performed, is included. The operative report should document the resection extent, pouch construction, anastomosis, and diversion. Medicare includes the day-before preoperative visit and related postoperative care through 90 days after surgery. When another procedure is 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. Report the combined operation as one procedure, not as paired-side services. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 44211 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

44211 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,783.69
Alaska*Unavailable$2,488.64
ArizonaUnavailable$1,885.33
ArkansasUnavailable$1,766.11
AtlantaUnavailable$1,974.44
AustinUnavailable$1,941.58
BakersfieldUnavailable$1,934.85
Baltimore/Surr. CntysUnavailable$2,027.53
BeaumontUnavailable$1,865.74
BrazoriaUnavailable$1,893.84

44211 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
44211 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 44211 rate is calculated

Each of 44211’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 · 44211

RVUs × geographic indexes × conversion factor

Work36.15

36.15 RVUs× 1.000 GPCI

Practice expense16.36

16.36 RVUs× 1.000 GPCI

Malpractice5.19

5.19 RVUs× 1.000 GPCI

Adjusted RVUs

57.7000

Conversion factor

$33.4009

Medicare rate

$1,927.23

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

Payment rules and modifiers for 44211

44211 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44211

Proctocolectomy

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 · 44211

Proctocolectomy

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

44211 without 51 · national facility

$1,927.23

Proctocolectomy

44211-51 · Second procedure: 50%

$963.62

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

44211 compared with similar codes

Compare codes · National

5 codes, side by side

  • 44211

    Proctocolectomy36.15 wRVU

    Not priced

  • 44210

    Total colectomy29.34 wRVU

    Not priced

  • 44212

    Proctocolectomy33.72 wRVU

    Not priced

  • 44207

    Colectomy31.12 wRVU

    Not priced

  • 44158

    Colectomy35.78 wRVU

    Not priced

How to choose

44210Total colectomy
44210 removes the colon without removing the rectum and may include ileostomy or ileoproctostomy. Choose 44211 when proctectomy and ileoanal pouch reconstruction are performed.
44212Proctocolectomy
44212 includes proctectomy with ileostomy but does not describe ileal pouch construction and ileoanal anastomosis. Those restorative steps distinguish 44211.
44207Colectomy
44207 describes a laparoscopic partial colectomy with a low pelvic anastomosis. It is not the code for total proctocolectomy with an ileal pouch.
44158Colectomy
44158 describes the open approach to total proctocolectomy with ileoanal pouch reconstruction; 44211 is for the laparoscopic approach.

Codes related to 44211

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

Codes related to 44211
CodeHow it relatesNational office range
Same family
44210Total colectomyTotal laparoscopic colectomy without proctectomy, with ileostomy or ileoproctostomy.No office rate
44212ProctocolectomyTotal laparoscopic proctocolectomy with ileostomy rather than ileoanal pouch reconstruction.No office rate
Add-on codes
44213Splenic flexureAdd-on for qualifying laparoscopic splenic flexure mobilization performed with this primary procedure.No office rate
Used instead
44207ColectomyFor laparoscopic partial colectomy with a low pelvic anastomosis, rather than total proctocolectomy with pouch creation.No office rate
44158ColectomyOpen approach to total proctocolectomy with ileoanal pouch reconstruction.No office rate

44211 billing questions

When should 44211 be chosen over 44212?

Use 44211 when the operation includes an ileal reservoir connected to the anus. Use 44212 for total proctocolectomy with an ileostomy when an ileoanal pouch reconstruction is not performed.

Is a diverting loop ileostomy separately reported?

The loop ileostomy, when performed as part of this operation, is included in 44211.

Can splenic flexure mobilization be reported separately?

Code 44213 is an add-on for qualifying laparoscopic splenic flexure mobilization performed with the primary colorectal procedure. Document the work performed and report it with the primary code.

What documentation supports reporting 44211?

The operative report should establish laparoscopic removal of the colon and rectum, ileal pouch construction, and ileoanal anastomosis, and state whether a loop ileostomy was created.

How should bilateral modifiers and the global period be handled?

Report the combined operation as one procedure rather than as right- and left-sided services. The 90-day global includes the day-before preoperative visit and related postoperative care.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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 44211PPRRVU2026_Oct_nonQPP.csv, line 5,374 (RVU26D)

Open CMS sourceHow we calculate rates

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