No office rate
Use 44187 for laparoscopic ileostomy or jejunostomy creation; 44188 creates a colonic stoma.
On this page
CMS RVU26D · Effective 2026-10-01
44188 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1146.26
Base rate per service
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.
Digestive surgery
About 44188: Laparoscopic colostomy creation
Report laparoscopic creation of a colonic stoma to divert intestinal contents, such as for obstruction, perforation, or protection of distal bowel.
The surgeon uses laparoscopic access to bring a portion of the colon to the abdominal wall and form a stoma. Colorectal and general surgeons commonly perform this operation in a hospital operating room to divert stool around distal obstruction, injury, inflammation, or a healing colorectal repair. The stoma may be intended as temporary diversion or long-term fecal diversion; the code identifies colonic rather than small-bowel ostomy creation.
Select 44188 when laparoscopic colostomy creation is the service performed, rather than a more extensive bowel-resection procedure that includes ostomy construction. The operative report should identify the laparoscopic approach, the colonic stoma created, and the clinical reason for diversion. Related preoperative care on the day before surgery and 90 days of postoperative care are included in the 90-day global period. When other procedures are 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. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 44188
- 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 RVU18.87 · 55%
- Practice expense (office) RVU11.04 · 32%
- Malpractice RVU4.21 · 12%
4.4K
Medicare services in 2024 · #1959 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.
44188 compared with similar codes
Office rates for Austin, from the same CMS release.
No office rate
44320 describes open colostomy creation. Choose 44188 when the stoma is created laparoscopically.
No office rate
44206 includes laparoscopic partial colectomy with end colostomy. It is the more appropriate service when that bowel resection and diversion are performed together.
The same code, a different location
How does Austin compare?
44188 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 44188
Office
Unavailable
Facility
$1107.19
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 44188
Office
Unavailable
Facility
$1185.71
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 44188
Office
Unavailable
Facility
$1255.20
No comparable office rate is available.
Miami
Florida · 44188
Office
Unavailable
Facility
$1369.76
No comparable office rate is available.
Chicago
Illinois · 44188
Office
Unavailable
Facility
$1327.99
No comparable office rate is available.
Manhattan
New York · 44188
Office
Unavailable
Facility
$1322.12
No comparable office rate is available.
Alaska*
Alaska · 44188
Office
Unavailable
Facility
$1415.61
No comparable office rate is available.
Alabama
Alabama · 44188
Office
Unavailable
Facility
$1032.52
No comparable office rate is available.
Arkansas
Arkansas · 44188
Office
Unavailable
Facility
$1019.45
No comparable office rate is available.
Arizona
Arizona · 44188
Office
Unavailable
Facility
$1107.96
No comparable office rate is available.
Bakersfield
California · 44188
Office
Unavailable
Facility
$1132.03
No comparable office rate is available.
Chico
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
El Centro
California · 44188
Office
Unavailable
Facility
$1121.21
No comparable office rate is available.
Fresno
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Hanford-Corcoran
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Madera
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Merced
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Modesto
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Napa
California · 44188
Office
Unavailable
Facility
$1227.42
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 44188
Office
Unavailable
Facility
$1171.39
No comparable office rate is available.
Redding
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Rest Of California
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 44188
Office
Unavailable
Facility
$1165.71
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 44188
Office
Unavailable
Facility
$1157.19
No comparable office rate is available.
Salinas
California · 44188
Office
Unavailable
Facility
$1152.56
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 44188
Office
Unavailable
Facility
$1166.42
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 44188
Office
Unavailable
Facility
$1274.63
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 44188
Office
Unavailable
Facility
$1269.85
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 44188
Office
Unavailable
Facility
$1306.71
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 44188
Office
Unavailable
Facility
$1287.16
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 44188
Office
Unavailable
Facility
$1136.36
No comparable office rate is available.
Santa Cruz-Watsonville
California · 44188
Office
Unavailable
Facility
$1166.91
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 44188
Office
Unavailable
Facility
$1153.25
No comparable office rate is available.
Santa Rosa-Petaluma
California · 44188
Office
Unavailable
Facility
$1177.37
No comparable office rate is available.
Stockton
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Vallejo
California · 44188
Office
Unavailable
Facility
$1220.53
No comparable office rate is available.
Visalia
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Yuba City
California · 44188
Office
Unavailable
Facility
$1120.51
No comparable office rate is available.
Colorado
Colorado · 44188
Office
Unavailable
Facility
$1140.01
No comparable office rate is available.
Connecticut
Connecticut · 44188
Office
Unavailable
Facility
$1210.17
No comparable office rate is available.
Delaware
Delaware · 44188
Office
Unavailable
Facility
$1124.16
No comparable office rate is available.
Fort Lauderdale
Florida · 44188
Office
Unavailable
Facility
$1258.05
No comparable office rate is available.
Rest Of Florida
Florida · 44188
Office
Unavailable
Facility
$1194.14
No comparable office rate is available.
Atlanta
Georgia · 44188
Office
Unavailable
Facility
$1175.69
No comparable office rate is available.
Rest Of Georgia
Georgia · 44188
Office
Unavailable
Facility
$1126.81
No comparable office rate is available.
Hawaii, Guam
Hawaii · 44188
Office
Unavailable
Facility
$1130.96
No comparable office rate is available.
Iowa
Iowa · 44188
Office
Unavailable
Facility
$1023.50
No comparable office rate is available.
Idaho
Idaho · 44188
Office
Unavailable
Facility
$1036.03
No comparable office rate is available.
East St. Louis
Illinois · 44188
Office
Unavailable
Facility
$1252.73
No comparable office rate is available.
Rest Of Illinois
Illinois · 44188
Office
Unavailable
Facility
$1186.73
No comparable office rate is available.
Suburban Chicago
Illinois · 44188
Office
Unavailable
Facility
$1262.56
No comparable office rate is available.
Indiana
Indiana · 44188
Office
Unavailable
Facility
$1040.44
No comparable office rate is available.
Kansas
Kansas · 44188
Office
Unavailable
Facility
$1034.49
No comparable office rate is available.
Kentucky
Kentucky · 44188
Office
Unavailable
Facility
$1086.76
No comparable office rate is available.
New Orleans
Louisiana · 44188
Office
Unavailable
Facility
$1137.01
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 44188
Office
Unavailable
Facility
$1091.33
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 44188
Office
Unavailable
Facility
$1221.55
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 44188
Office
Unavailable
Facility
$1140.72
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 44188
Office
Unavailable
Facility
$1209.97
No comparable office rate is available.
Rest Of Maryland
Maryland · 44188
Office
Unavailable
Facility
$1138.84
No comparable office rate is available.
Rest Of Maine
Maine · 44188
Office
Unavailable
Facility
$1056.99
No comparable office rate is available.
Southern Maine
Maine · 44188
Office
Unavailable
Facility
$1084.43
No comparable office rate is available.
Detroit
Michigan · 44188
Office
Unavailable
Facility
$1223.20
No comparable office rate is available.
Rest Of Michigan
Michigan · 44188
Office
Unavailable
Facility
$1125.70
No comparable office rate is available.
Minnesota
Minnesota · 44188
Office
Unavailable
Facility
$1051.34
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 44188
Office
Unavailable
Facility
$1113.91
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 44188
Office
Unavailable
Facility
$1122.22
No comparable office rate is available.
Rest Of Missouri
Missouri · 44188
Office
Unavailable
Facility
$1085.10
No comparable office rate is available.
Mississippi
Mississippi · 44188
Office
Unavailable
Facility
$1051.68
No comparable office rate is available.
Montana**
Montana · 44188
Office
Unavailable
Facility
$1139.36
No comparable office rate is available.
North Carolina
North Carolina · 44188
Office
Unavailable
Facility
$1064.17
No comparable office rate is available.
North Dakota**
North Dakota · 44188
Office
Unavailable
Facility
$1056.11
No comparable office rate is available.
Nebraska
Nebraska · 44188
Office
Unavailable
Facility
$1023.78
No comparable office rate is available.
New Hampshire
New Hampshire · 44188
Office
Unavailable
Facility
$1137.18
No comparable office rate is available.
Northern Nj
New Jersey · 44188
Office
Unavailable
Facility
$1247.91
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 44188
Office
Unavailable
Facility
$1212.41
No comparable office rate is available.
New Mexico
New Mexico · 44188
Office
Unavailable
Facility
$1137.30
No comparable office rate is available.
Nevada**
Nevada · 44188
Office
Unavailable
Facility
$1116.52
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 44188
Office
Unavailable
Facility
$1370.18
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 44188
Office
Unavailable
Facility
$1232.56
No comparable office rate is available.
Queens
New York · 44188
Office
Unavailable
Facility
$1309.24
No comparable office rate is available.
Rest Of New York
New York · 44188
Office
Unavailable
Facility
$1079.44
No comparable office rate is available.
Ohio
Ohio · 44188
Office
Unavailable
Facility
$1108.68
No comparable office rate is available.
Oklahoma
Oklahoma · 44188
Office
Unavailable
Facility
$1068.83
No comparable office rate is available.
Portland
Oregon · 44188
Office
Unavailable
Facility
$1154.66
No comparable office rate is available.
Rest Of Oregon
Oregon · 44188
Office
Unavailable
Facility
$1096.40
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 44188
Office
Unavailable
Facility
$1193.24
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 44188
Office
Unavailable
Facility
$1101.67
No comparable office rate is available.
Puerto Rico
Puerto Rico · 44188
Office
Unavailable
Facility
$1141.59
No comparable office rate is available.
Rhode Island
Rhode Island · 44188
Office
Unavailable
Facility
$1148.60
No comparable office rate is available.
South Carolina
South Carolina · 44188
Office
Unavailable
Facility
$1090.52
No comparable office rate is available.
South Dakota**
South Dakota · 44188
Office
Unavailable
Facility
$1046.27
No comparable office rate is available.
Tennessee
Tennessee · 44188
Office
Unavailable
Facility
$1040.98
No comparable office rate is available.
Utah
Utah · 44188
Office
Unavailable
Facility
$1103.17
No comparable office rate is available.
Virginia
Virginia · 44188
Office
Unavailable
Facility
$1092.03
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 44188
Office
Unavailable
Facility
$1141.59
No comparable office rate is available.
Vermont
Vermont · 44188
Office
Unavailable
Facility
$1066.49
No comparable office rate is available.
Rest Of Washington
Washington · 44188
Office
Unavailable
Facility
$1133.77
No comparable office rate is available.
Seattle (King Cnty)
Washington · 44188
Office
Unavailable
Facility
$1229.12
No comparable office rate is available.
Wisconsin
Wisconsin · 44188
Office
Unavailable
Facility
$1026.84
No comparable office rate is available.
West Virginia
West Virginia · 44188
Office
Unavailable
Facility
$1151.94
No comparable office rate is available.
Wyoming**
Wyoming · 44188
Office
Unavailable
Facility
$1103.08
No comparable office rate is available.
See how rates vary across the country
44188 · 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 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 44188 in Austin
Multiple payment areas
- 44188 in Barton Creek
- 44188 in Bee Cave
- 44188 in Briarcliff
- 44188 in Cedar Park
Multiple payment areas
- 44188 in Creedmoor
Multiple payment areas
- 44188 in Elgin
Multiple payment areas
- 44188 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 44188 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1260.89
$1146.26 × 110% = $1260.89
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 44188 in Austin.
PPRRVU2026_Oct_nonQPP.csv
5,365
- Code
- 44188
- Physician work
- 18.87
- Practice expense
- 11.04
- Malpractice
- 4.21
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.87 | × 1.002 | 18.9077 |
| Practice expense | 11.04 | × 1.058 | 11.6803 |
| Malpractice | 4.21 | × 0.886 | 3.7301 |
| Total RVUs | 34.3181 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$1146.26
Open 44188 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.87 | 1.002 |
| Practice expense | 11.04 | 1.058 |
| Malpractice | 4.21 | 0.886 |
(18.87 × 1.002 + 11.04 × 1.058 + 4.21 × 0.886) × $33.4009 = $1146.26
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
44188 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1146.26 | RVU26D |
| 2026-07-01 | Not available in this setting | $1146.26 | RVU26C |
| 2026-04-01 | Not available in this setting | $1146.26 | RVU26B |
| 2026-01-01 | Not available in this setting | $1146.26 | RVU26A |
| 2025-10-01 | Not available in this setting | $1184.72 | RVU25D |
| 2025-07-01 | Not available in this setting | $1184.72 | RVU25C |
| 2025-04-01 | Not available in this setting | $1184.72 | RVU25B |
| 2025-01-01 | Not available in this setting | $1184.72 | RVU25A |
44188 billing questions
How does 44188 differ from a laparoscopic ileostomy?
44188 is for creating a colonic stoma. Use 44187 for laparoscopic ileostomy or jejunostomy creation.
Can 44188 be reported separately with a colectomy?
When a colectomy code describes the resection and associated ostomy construction, report that comprehensive procedure rather than separately reporting 44188 for the stoma.
What is the difference between 44188 and 44320?
Both describe colostomy creation, but 44188 is laparoscopic and 44320 is the open approach.
What documentation supports 44188?
The operative report should establish laparoscopic access, creation of a colonic stoma, and the indication for diversion. It should also make clear whether bowel resection was part of the operation.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be available for 44188. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,36244180,,Lap enterolysis,A,,14.89,7.20,NA,7.20,,3.79,25.88,25.88,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36344186,,Lap jejunostomy,A,,10.12,6.00,NA,6.00,,2.59,18.71,18.71,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36444187,,Lap ileo/jejuno-stomy,A,,16.97,10.31,NA,10.31,,3.40,30.68,30.68,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36544188,,Lap colostomy,A,,18.87,11.04,NA,11.04,,4.21,34.12,34.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36644202,,Lap enterectomy,A,,22.81,10.19,NA,10.19,,5.59,38.59,38.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36744203,,Lap resect s/intestine addl,A,,4.33,1.07,NA,1.07,,1.07,6.47,6.47,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36844204,,Laparo partial colectomy,A,,25.76,10.80,NA,10.80,,5.75,42.31,42.31,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858