No office rate
44158 includes construction of an ileal reservoir for the ileoanal anastomosis; 44157 describes direct ileoanal anastomosis without a reservoir.
On this page
CMS RVU26D · Effective 2026-10-01
44157 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1972.00
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.
Colorectal surgery
About 44157: Total proctocolectomy with ileoanal anastomosis
Reports open removal of the colon and rectum with direct connection of the ileum to the anus, including a diverting loop ileostomy.
This operation removes the colon and rectum and joins the end of the ileum directly to the anus, without constructing an ileal reservoir. A diverting loop ileostomy is included. Colorectal surgeons commonly perform it for conditions such as ulcerative colitis or familial adenomatous polyposis when the rectum is also removed and an ileoanal connection is planned. The code describes an open operation, typically performed in a hospital operating room.
Select the code when the operative report supports removal of both colon and rectum and a direct ileoanal anastomosis; distinguish it from procedures that leave the rectum, create a reservoir, or end in a different type of ileostomy. Document the resection, reconstruction, and diversion performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate.
CMS billing rules for 44157
- 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 RVU34.81 · 57%
- Practice expense (office) RVU17.01 · 28%
- Malpractice RVU9.32 · 15%
25
Medicare services in 2024 · #5792 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.
44157 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
Both include total colectomy and proctectomy, but 44155 ends in an ileostomy rather than connecting ileum to the anus.
No office rate
44150 removes the colon without proctectomy. Choose 44157 when the rectum is also removed and an ileoanal anastomosis is performed.
No office rate
44211 describes the laparoscopic approach for the corresponding total colectomy, proctectomy, and ileoanal anastomosis; 44157 is for the open operation.
The same code, a different location
How does Modesto compare?
44157 across payment areas
Same release and payment basis · bars start at $0
Modesto · 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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Madera
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Merced
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Napa
California · 44157
Office
Unavailable
Facility
$2142.89
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 44157
Office
Unavailable
Facility
$2060.73
No comparable office rate is available.
Redding
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Rest Of California
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 44157
Office
Unavailable
Facility
$2071.84
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 44157
Office
Unavailable
Facility
$2032.15
No comparable office rate is available.
Salinas
California · 44157
Office
Unavailable
Facility
$2024.07
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 44157
Office
Unavailable
Facility
$2045.80
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 44157
Office
Unavailable
Facility
$2217.12
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 44157
Office
Unavailable
Facility
$2206.53
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 44157
Office
Unavailable
Facility
$2276.71
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 44157
Office
Unavailable
Facility
$2233.44
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 44157
Office
Unavailable
Facility
$1996.43
No comparable office rate is available.
Santa Cruz-Watsonville
California · 44157
Office
Unavailable
Facility
$2044.26
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 44157
Office
Unavailable
Facility
$2024.56
No comparable office rate is available.
Santa Rosa-Petaluma
California · 44157
Office
Unavailable
Facility
$2062.11
No comparable office rate is available.
Stockton
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Vallejo
California · 44157
Office
Unavailable
Facility
$2127.64
No comparable office rate is available.
Visalia
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Yuba City
California · 44157
Office
Unavailable
Facility
$1972.00
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 44157
Office
Unavailable
Facility
$2241.22
No comparable office rate is available.
Miami
Florida · 44157
Office
Unavailable
Facility
$2541.40
No comparable office rate is available.
Chicago
Illinois · 44157
Office
Unavailable
Facility
$2456.24
No comparable office rate is available.
Manhattan
New York · 44157
Office
Unavailable
Facility
$2391.00
No comparable office rate is available.
Alaska*
Alaska · 44157
Office
Unavailable
Facility
$2520.63
No comparable office rate is available.
Alabama
Alabama · 44157
Office
Unavailable
Facility
$1836.01
No comparable office rate is available.
Arkansas
Arkansas · 44157
Office
Unavailable
Facility
$1811.04
No comparable office rate is available.
Arizona
Arizona · 44157
Office
Unavailable
Facility
$1979.69
No comparable office rate is available.
Colorado
Colorado · 44157
Office
Unavailable
Facility
$2024.27
No comparable office rate is available.
Connecticut
Connecticut · 44157
Office
Unavailable
Facility
$2174.50
No comparable office rate is available.
Delaware
Delaware · 44157
Office
Unavailable
Facility
$2009.69
No comparable office rate is available.
Fort Lauderdale
Florida · 44157
Office
Unavailable
Facility
$2301.04
No comparable office rate is available.
Rest Of Florida
Florida · 44157
Office
Unavailable
Facility
$2173.71
No comparable office rate is available.
Atlanta
Georgia · 44157
Office
Unavailable
Facility
$2117.28
No comparable office rate is available.
Rest Of Georgia
Georgia · 44157
Office
Unavailable
Facility
$2040.54
No comparable office rate is available.
Hawaii, Guam
Hawaii · 44157
Office
Unavailable
Facility
$1988.91
No comparable office rate is available.
Iowa
Iowa · 44157
Office
Unavailable
Facility
$1806.13
No comparable office rate is available.
Idaho
Idaho · 44157
Office
Unavailable
Facility
$1832.63
No comparable office rate is available.
East St. Louis
Illinois · 44157
Office
Unavailable
Facility
$2312.33
No comparable office rate is available.
Rest Of Illinois
Illinois · 44157
Office
Unavailable
Facility
$2167.96
No comparable office rate is available.
Suburban Chicago
Illinois · 44157
Office
Unavailable
Facility
$2305.93
No comparable office rate is available.
Indiana
Indiana · 44157
Office
Unavailable
Facility
$1840.65
No comparable office rate is available.
Kansas
Kansas · 44157
Office
Unavailable
Facility
$1833.19
No comparable office rate is available.
Kentucky
Kentucky · 44157
Office
Unavailable
Facility
$1952.61
No comparable office rate is available.
New Orleans
Louisiana · 44157
Office
Unavailable
Facility
$2050.95
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 44157
Office
Unavailable
Facility
$1963.72
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 44157
Office
Unavailable
Facility
$2165.78
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 44157
Office
Unavailable
Facility
$2027.65
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 44157
Office
Unavailable
Facility
$2175.99
No comparable office rate is available.
Rest Of Maryland
Maryland · 44157
Office
Unavailable
Facility
$2035.05
No comparable office rate is available.
Rest Of Maine
Maine · 44157
Office
Unavailable
Facility
$1879.01
No comparable office rate is available.
Southern Maine
Maine · 44157
Office
Unavailable
Facility
$1922.15
No comparable office rate is available.
Detroit
Michigan · 44157
Office
Unavailable
Facility
$2235.80
No comparable office rate is available.
Rest Of Michigan
Michigan · 44157
Office
Unavailable
Facility
$2032.86
No comparable office rate is available.
Minnesota
Minnesota · 44157
Office
Unavailable
Facility
$1839.45
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 44157
Office
Unavailable
Facility
$2000.31
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 44157
Office
Unavailable
Facility
$2015.48
No comparable office rate is available.
Rest Of Missouri
Missouri · 44157
Office
Unavailable
Facility
$1955.63
No comparable office rate is available.
Mississippi
Mississippi · 44157
Office
Unavailable
Facility
$1881.91
No comparable office rate is available.
Montana**
Montana · 44157
Office
Unavailable
Facility
$2041.51
No comparable office rate is available.
North Carolina
North Carolina · 44157
Office
Unavailable
Facility
$1891.69
No comparable office rate is available.
North Dakota**
North Dakota · 44157
Office
Unavailable
Facility
$1857.22
No comparable office rate is available.
Nebraska
Nebraska · 44157
Office
Unavailable
Facility
$1804.76
No comparable office rate is available.
New Hampshire
New Hampshire · 44157
Office
Unavailable
Facility
$2026.51
No comparable office rate is available.
Northern Nj
New Jersey · 44157
Office
Unavailable
Facility
$2227.45
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 44157
Office
Unavailable
Facility
$2171.10
No comparable office rate is available.
New Mexico
New Mexico · 44157
Office
Unavailable
Facility
$2057.55
No comparable office rate is available.
Nevada**
Nevada · 44157
Office
Unavailable
Facility
$1990.71
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 44157
Office
Unavailable
Facility
$2490.70
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 44157
Office
Unavailable
Facility
$2213.80
No comparable office rate is available.
Queens
New York · 44157
Office
Unavailable
Facility
$2357.54
No comparable office rate is available.
Rest Of New York
New York · 44157
Office
Unavailable
Facility
$1921.27
No comparable office rate is available.
Ohio
Ohio · 44157
Office
Unavailable
Facility
$1995.19
No comparable office rate is available.
Oklahoma
Oklahoma · 44157
Office
Unavailable
Facility
$1911.92
No comparable office rate is available.
Portland
Oregon · 44157
Office
Unavailable
Facility
$2044.11
No comparable office rate is available.
Rest Of Oregon
Oregon · 44157
Office
Unavailable
Facility
$1947.40
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 44157
Office
Unavailable
Facility
$2146.43
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 44157
Office
Unavailable
Facility
$1978.42
No comparable office rate is available.
Puerto Rico
Puerto Rico · 44157
Office
Unavailable
Facility
$2043.71
No comparable office rate is available.
Rhode Island
Rhode Island · 44157
Office
Unavailable
Facility
$2049.35
No comparable office rate is available.
South Carolina
South Carolina · 44157
Office
Unavailable
Facility
$1952.26
No comparable office rate is available.
South Dakota**
South Dakota · 44157
Office
Unavailable
Facility
$1835.43
No comparable office rate is available.
Tennessee
Tennessee · 44157
Office
Unavailable
Facility
$1846.30
No comparable office rate is available.
Austin
Texas · 44157
Office
Unavailable
Facility
$2041.92
No comparable office rate is available.
Beaumont
Texas · 44157
Office
Unavailable
Facility
$1968.90
No comparable office rate is available.
Brazoria
Texas · 44157
Office
Unavailable
Facility
$1977.83
No comparable office rate is available.
Dallas
Texas · 44157
Office
Unavailable
Facility
$2006.12
No comparable office rate is available.
Fort Worth
Texas · 44157
Office
Unavailable
Facility
$2004.48
No comparable office rate is available.
Galveston
Texas · 44157
Office
Unavailable
Facility
$1993.91
No comparable office rate is available.
Houston
Texas · 44157
Office
Unavailable
Facility
$2164.50
No comparable office rate is available.
Rest Of Texas
Texas · 44157
Office
Unavailable
Facility
$1982.96
No comparable office rate is available.
Utah
Utah · 44157
Office
Unavailable
Facility
$1976.29
No comparable office rate is available.
Virginia
Virginia · 44157
Office
Unavailable
Facility
$1940.95
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 44157
Office
Unavailable
Facility
$2043.71
No comparable office rate is available.
Vermont
Vermont · 44157
Office
Unavailable
Facility
$1882.67
No comparable office rate is available.
Rest Of Washington
Washington · 44157
Office
Unavailable
Facility
$2012.96
No comparable office rate is available.
Seattle (King Cnty)
Washington · 44157
Office
Unavailable
Facility
$2172.27
No comparable office rate is available.
Wisconsin
Wisconsin · 44157
Office
Unavailable
Facility
$1802.85
No comparable office rate is available.
West Virginia
West Virginia · 44157
Office
Unavailable
Facility
$2101.87
No comparable office rate is available.
Wyoming**
Wyoming · 44157
Office
Unavailable
Facility
$1961.19
No comparable office rate is available.
See how rates vary across the country
44157 · 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?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 44157 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2169.20
$1972.00 × 110% = $2169.20
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 44157 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
5,359
- Code
- 44157
- Physician work
- 34.81
- Practice expense
- 17.01
- Malpractice
- 9.32
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 34.81 | × 1.017 | 35.4018 |
| Practice expense | 17.01 | × 1.096 | 18.6430 |
| Malpractice | 9.32 | × 0.536 | 4.9955 |
| Total RVUs | 59.0403 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$1972.00
Open 44157 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 34.81 | 1.017 |
| Practice expense | 17.01 | 1.096 |
| Malpractice | 9.32 | 0.536 |
(34.81 × 1.017 + 17.01 × 1.096 + 9.32 × 0.536) × $33.4009 = $1972.00
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
44157 · 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 | $1972.00 | RVU26D |
| 2026-07-01 | Not available in this setting | $1972.00 | RVU26C |
| 2026-04-01 | Not available in this setting | $1972.00 | RVU26B |
| 2026-01-01 | Not available in this setting | $1972.00 | RVU26A |
| 2025-10-01 | Not available in this setting | $2070.80 | RVU25D |
| 2025-07-01 | Not available in this setting | $2070.80 | RVU25C |
| 2025-04-01 | Not available in this setting | $2070.80 | RVU25B |
| 2025-01-01 | Not available in this setting | $2070.80 | RVU25A |
44157 billing questions
When is this code chosen instead of 44158?
Use 44157 for a direct ileoanal connection without an ileal reservoir. When the surgeon constructs an ileal reservoir or pouch for the anal anastomosis, compare 44158.
Is the loop ileostomy separately reported?
No. The loop ileostomy used to divert the ileoanal anastomosis is included in this procedure.
How does 44157 differ from 44155?
44157 includes an ileoanal anastomosis and loop ileostomy. 44155 describes total colectomy with proctectomy ending in an ileostomy rather than an ileoanal anastomosis.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not describe this operation.
What supports reporting 44157?
The operative report should establish removal of the colon and rectum, direct ileoanal anastomosis, and any included loop ileostomy. It should also make clear whether a reservoir was constructed.
How are assistant and co-surgeon services handled?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; 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.
5,35644151,,Removal of colon/ileostomy,A,,34.05,17.03,NA,17.03,,9.13,60.21,60.21,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,35744155,,Removal of colon/ileostomy,A,,33.56,16.46,NA,16.46,,7.47,57.49,57.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,35844156,,Removal of colon/ileostomy,A,,36.48,18.03,NA,18.03,,9.79,64.30,64.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,35944157,,Colectomy w/ileoanal anast,A,,34.81,17.01,NA,17.01,,9.32,61.14,61.14,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36044158,,Colectomy w/neo-rectum pouch,A,,35.78,17.25,NA,17.25,,9.58,62.61,62.61,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36144160,,Removal of colon,A,,20.37,9.38,NA,9.38,,4.90,34.65,34.65,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36244180,,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
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536