No office rate
44210 describes total colectomy without proctectomy. This code includes removal of the rectum and ileal pouch reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
44212 Proctocolectomy Medicare reimbursement rates
Reports laparoscopic removal of the colon and rectum with ileal pouch construction, ileoanal connection, and a diverting loop ileostomy. Compare 44212 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 44212?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 44212 pays more and less
Digestive surgery
About 44212: Laparoscopic total proctocolectomy with pouch
Reports laparoscopic removal of the colon and rectum with ileal pouch construction, ileoanal connection, and a diverting loop ileostomy.
A colorectal surgeon performs this operation laparoscopically to remove the entire colon and rectum, construct a reservoir from the ileum, connect it to the anus, and create a temporary loop ileostomy to divert stool. It is commonly performed for conditions such as ulcerative colitis or familial adenomatous polyposis when removal of the colon and rectum with an ileal pouch is planned. The service is typically performed in a hospital operating room.
Select this code when the operative report supports the laparoscopic approach, total colon and rectum removal, ileal pouch reconstruction, and loop ileostomy. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 44212
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU33.72 · 60%
- Practice expense (office) RVU16.01 · 29%
- Malpractice RVU6.02 · 11%
160
Medicare services in 2024 · #4512 by national volume
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.
44212 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
44211 includes total colectomy and proctectomy with ileostomy, but not the ileal pouch and ileoanal connection described here.
No office rate
44204 is for laparoscopic partial colectomy, not removal of the entire colon and rectum with pouch reconstruction.
See how rates vary across the country
44212 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 44212 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1707.99 |
| Alaska* | Office Unavailable | Facility $2369.72 |
| Arizona | Office Unavailable | Facility $1816.57 |
| Arkansas | Office Unavailable | Facility $1689.18 |
| Atlanta | Office Unavailable | Facility $1914.45 |
| Austin | Office Unavailable | Facility $1872.45 |
| Bakersfield | Office Unavailable | Facility $1856.22 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1966.81 |
| Beaumont | Office Unavailable | Facility $1799.70 |
| Brazoria | Office Unavailable | Facility $1822.06 |
| Chicago | Office Unavailable | Facility $2133.05 |
| Chico | Office Unavailable | Facility $1839.28 |
| Colorado | Office Unavailable | Facility $1865.80 |
| Connecticut | Office Unavailable | Facility $1968.03 |
| Dallas | Office Unavailable | Facility $1841.55 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $2040.83 |
| Delaware | Office Unavailable | Facility $1841.01 |
| Detroit | Office Unavailable | Facility $1981.32 |
| East St. Louis | Office Unavailable | Facility $2023.21 |
| El Centro | Office Unavailable | Facility $1840.29 |
| Fort Lauderdale | Office Unavailable | Facility $2031.52 |
| Fort Worth | Office Unavailable | Facility $1838.81 |
| Fresno | Office Unavailable | Facility $1839.28 |
| Galveston | Office Unavailable | Facility $1832.78 |
| Hanford-Corcoran | Office Unavailable | Facility $1839.28 |
| Hawaii, Guam | Office Unavailable | Facility $1850.71 |
| Houston | Office Unavailable | Facility $1942.97 |
| Idaho | Office Unavailable | Facility $1713.35 |
| Indiana | Office Unavailable | Facility $1719.71 |
| Iowa | Office Unavailable | Facility $1695.40 |
| Kansas | Office Unavailable | Facility $1711.03 |
| Kentucky | Office Unavailable | Facility $1785.65 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1938.58 |
| Madera | Office Unavailable | Facility $1839.28 |
| Manhattan | Office Unavailable | Facility $2138.64 |
| Merced | Office Unavailable | Facility $1839.28 |
| Metropolitan Boston | Office Unavailable | Facility $1989.90 |
| Metropolitan Kansas City | Office Unavailable | Facility $1824.86 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1943.11 |
| Metropolitan St. Louis | Office Unavailable | Facility $1836.83 |
| Miami | Office Unavailable | Facility $2191.47 |
| Minnesota | Office Unavailable | Facility $1736.05 |
| Mississippi | Office Unavailable | Facility $1735.29 |
| Modesto | Office Unavailable | Facility $1839.28 |
| Montana** | Office Unavailable | Facility $1861.70 |
| Napa | Office Unavailable | Facility $2004.18 |
| Nebraska | Office Unavailable | Facility $1695.86 |
| Nevada** | Office Unavailable | Facility $1829.06 |
| New Hampshire | Office Unavailable | Facility $1858.89 |
| New Mexico | Office Unavailable | Facility $1858.13 |
| New Orleans | Office Unavailable | Facility $1857.90 |
| North Carolina | Office Unavailable | Facility $1753.68 |
| North Dakota** | Office Unavailable | Facility $1742.66 |
| Northern Nj | Office Unavailable | Facility $2032.29 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $2207.57 |
| Ohio | Office Unavailable | Facility $1817.19 |
| Oklahoma | Office Unavailable | Facility $1760.04 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1915.16 |
| Portland | Office Unavailable | Facility $1888.00 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $2005.81 |
| Puerto Rico | Office Unavailable | Facility $1864.97 |
| Queens | Office Unavailable | Facility $2120.38 |
| Redding | Office Unavailable | Facility $1839.28 |
| Rest Of California | Office Unavailable | Facility $1839.28 |
| Rest Of Florida | Office Unavailable | Facility $1939.71 |
| Rest Of Georgia | Office Unavailable | Facility $1842.95 |
| Rest Of Illinois | Office Unavailable | Facility $1928.78 |
| Rest Of Louisiana | Office Unavailable | Facility $1792.16 |
| Rest Of Maine | Office Unavailable | Facility $1743.31 |
| Rest Of Maryland | Office Unavailable | Facility $1863.29 |
| Rest Of Massachusetts | Office Unavailable | Facility $1867.64 |
| Rest Of Michigan | Office Unavailable | Facility $1841.52 |
| Rest Of Missouri | Office Unavailable | Facility $1783.08 |
| Rest Of New Jersey | Office Unavailable | Facility $1975.85 |
| Rest Of New York | Office Unavailable | Facility $1775.64 |
| Rest Of Oregon | Office Unavailable | Facility $1800.24 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1807.19 |
| Rest Of Texas | Office Unavailable | Facility $1815.32 |
| Rest Of Washington | Office Unavailable | Facility $1857.03 |
| Rhode Island | Office Unavailable | Facility $1879.43 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1904.15 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1896.51 |
| Salinas | Office Unavailable | Facility $1888.74 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1908.61 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2079.56 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2072.73 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2129.05 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2101.10 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1862.28 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1907.42 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1889.11 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1924.51 |
| Seattle (King Cnty) | Office Unavailable | Facility $2003.01 |
| South Carolina | Office Unavailable | Facility $1791.30 |
| South Dakota** | Office Unavailable | Facility $1728.59 |
| Southern Maine | Office Unavailable | Facility $1783.09 |
| Stockton | Office Unavailable | Facility $1839.28 |
| Suburban Chicago | Office Unavailable | Facility $2039.65 |
| Tennessee | Office Unavailable | Facility $1720.34 |
| Utah | Office Unavailable | Facility $1809.51 |
| Vallejo | Office Unavailable | Facility $1994.32 |
| Vermont | Office Unavailable | Facility $1757.42 |
| Virgin Islands | Office Unavailable | Facility $1864.97 |
| Virginia | Office Unavailable | Facility $1793.89 |
| Visalia | Office Unavailable | Facility $1839.28 |
| West Virginia | Office Unavailable | Facility $1878.71 |
| Wisconsin | Office Unavailable | Facility $1700.50 |
| Wyoming** | Office Unavailable | Facility $1809.82 |
| Yuba City | Office Unavailable | Facility $1839.28 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
44212 billing questions
How does this differ from a total proctocolectomy without a pouch?
This code describes ileal pouch construction with an ileoanal connection and diverting loop ileostomy. Use a different code when the operative reconstruction does not include those elements.
Is the ileal pouch separately reported?
The pouch construction is part of this operation when performed as described. The operative report should document the reconstruction and ileoanal connection.
What documentation supports reporting this code?
Document the laparoscopic approach, removal of the entire colon and rectum, ileal reservoir construction, ileoanal connection, and loop ileostomy.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,37244208,,L colectomy/coloproctostomy,A,,33.14,14.10,NA,14.10,,6.71,53.95,53.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37344210,,Laparo total proctocolectomy,A,,29.34,13.86,NA,13.86,,5.53,48.73,48.73,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37444211,,Lap colectomy w/proctectomy,A,,36.15,16.36,NA,16.36,,5.19,57.70,57.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37544212,,Laparo total proctocolectomy,A,,33.72,16.01,NA,16.01,,6.02,55.75,55.75,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37644213,,Lap mobil splenic fl add-on,A,,3.41,0.83,NA,0.83,,0.70,4.94,4.94,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37744227,,Lap close enterostomy,A,,27.90,11.39,NA,11.39,,6.20,45.49,45.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37844238,,Unlisted laps px intestine,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00