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 Proctocolectomy Medicare reimbursement rates in Arizona
Reports open removal of the colon and rectum with direct connection of the ileum to the anus, including a diverting loop ileostomy. Compare 44157 office and facility rates across CMS payment localities in Arizona.
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 44157 in Arizona?
Arizona has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1979.69
1 of 1 localities have a supported rate.
Payment area: Arizona
One mapped payment locality.
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.
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 Arizona, 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.
Compare 44157 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.
1 of 1 payment localities
Arizona →
Office / nonfacility
Unavailable
Facility
$1979.69
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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 Arizona.
PPRRVU2026_Oct_nonQPP.csv
5,359
- Code
- 44157
- Physician work
- 34.81
- Practice expense
- 17.01
- Malpractice
- 9.32
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 34.81 | × 1.000 | 34.8100 |
| Practice expense | 17.01 | × 0.969 | 16.4827 |
| Malpractice | 9.32 | × 0.856 | 7.9779 |
| Total RVUs | 59.2706 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$1979.69
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 34.81 | 1 |
| Practice expense | 17.01 | 0.969 |
| Malpractice | 9.32 | 0.856 |
(34.81 × 1 + 17.01 × 0.969 + 9.32 × 0.856) × $33.4009 = $1979.69
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.
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
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536