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Billing code 44316: Continent ileostomyMedicare rate & RVUs

Reports surgical construction of a continent ileal reservoir, such as a Kock pouch, that stores intestinal contents and empties through a catheterized stoma.

CMS RVU26DEffective Oct 1, 2026109 payment localities16 Medicare services in 2024

Medicare pays $1,324.35 for 44316 nationally in a facility.

Medicare rate · 44316

Continent ileostomy

Work RVUs
23
Total RVUs
39.65
Global days
090

National rate · 2026

$1,324.35

Facility setting, before claim adjustments.

See every locality for 44316 →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 44316 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 44316 covers

This operation creates an internal reservoir from small bowel and forms a continent outlet at the abdominal wall. The patient empties the pouch by passing a catheter through the stoma rather than collecting output continuously in an external ostomy appliance. A colorectal or general surgeon may perform it for a patient requiring ileal diversion, including selected patients after colectomy for ulcerative colitis or familial adenomatous polyposis. The operative report should identify the reservoir and continent outlet being constructed.

Report 44316 when the continent ileostomy construction is the service represented, rather than a conventional ileostomy. When the surgeon performs it as part of a comprehensive colectomy that includes a continent ileostomy, use the applicable colectomy code instead of separately reporting the pouch construction. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For other procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 44316 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

44316 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,191.25
Alaska*Unavailable$1,638.85
ArizonaUnavailable$1,283.86
ArkansasUnavailable$1,175.15
AtlantaUnavailable$1,373.61
AustinUnavailable$1,322.75
BakersfieldUnavailable$1,292.13
Baltimore/Surr. CntysUnavailable$1,410.98
BeaumontUnavailable$1,278.20
BrazoriaUnavailable$1,282.07

44316 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
44316 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 44316 rate is calculated

Each of 44316’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 · 44316

RVUs × geographic indexes × conversion factor

Work23.00

23.00 RVUs× 1.000 GPCI

Practice expense10.49

10.49 RVUs× 1.000 GPCI

Malpractice6.16

6.16 RVUs× 1.000 GPCI

Adjusted RVUs

39.6500

Conversion factor

$33.4009

Medicare rate

$1,324.35

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

Payment rules and modifiers for 44316

44316 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44316

Continent ileostomy

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 · 44316

Continent ileostomy

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

44316 without 51 · national facility

$1,324.35

Continent ileostomy

44316-51 · Second procedure: 50%

$662.18

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

44316 compared with similar codes

Compare codes · National

5 codes, side by side

  • 44316

    Continent ileostomy23 wRVU

    Not priced

  • 44310

    Small-bowel stoma17.15 wRVU

    Not priced

  • 44151

    Total colectomy34.05 wRVU

    Not priced

  • 44156

    Colectomy36.48 wRVU

    Not priced

  • 44312

    Ileostomy revision9.19 wRVU

    Not priced

How to choose

44310Small-bowel stoma
Use 44316 for construction of a continent reservoir and catheterized outlet; 44310 describes a conventional ileostomy or jejunostomy.
44151Total colectomy
44151 includes continent ileostomy creation with total abdominal colectomy without proctectomy. Use 44316 when reporting the pouch construction itself rather than that combined colectomy service.
44156Colectomy
44156 includes continent ileostomy creation with total abdominal colectomy and proctectomy. It represents the broader combined operation, not pouch construction alone.
44312Ileostomy revision
44312 describes revision of an existing ileostomy; 44316 creates a continent ileal reservoir.

Codes related to 44316

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

Codes related to 44316
CodeHow it relatesNational office range
Used instead
44310Small-bowel stomaDescribes a conventional ileostomy or jejunostomy rather than a continent reservoir.No office rate
Component of
44151Total colectomyIncludes continent ileostomy creation with total abdominal colectomy without proctectomy.No office rate
44156ColectomyIncludes continent ileostomy creation with total abdominal colectomy and proctectomy.No office rate

44316 billing questions

How does 44316 differ from 44310?

44316 creates an internal reservoir with a continent catheterized outlet. 44310 describes a conventional ileostomy or jejunostomy rather than this pouch construction.

Can 44316 be reported with a colectomy code?

When the colectomy code includes creation of a continent ileostomy, report the applicable comprehensive colectomy code rather than separately reporting 44316 for the included pouch construction.

Does modifier 50 apply?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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 44316PPRRVU2026_Oct_nonQPP.csv, line 5,383 (RVU26D)

Open CMS sourceHow we calculate rates

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