No office rate
This open closure code applies when the enterostomy is closed without bowel resection; 44227 describes laparoscopic closure with resection and anastomosis.
On this page
CMS RVU26D · Effective 2026-10-01
44227 Enterostomy closure Medicare reimbursement rates in Arkansas
Reports laparoscopic reversal of a small- or large-bowel enterostomy when the stoma-bearing segment is resected and intestinal continuity is restored. Compare 44227 office and facility rates across CMS payment localities in Arkansas.
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 44227 in Arkansas?
Arkansas 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
$1365.33
1 of 1 localities have a supported rate.
Payment area: Arkansas
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.
Intestinal surgery
About 44227: Laparoscopic enterostomy closure with resection
Reports laparoscopic reversal of a small- or large-bowel enterostomy when the stoma-bearing segment is resected and intestinal continuity is restored.
The surgeon closes an enterostomy using a laparoscopic approach, removes the stoma-bearing bowel segment, and restores intestinal continuity with an anastomosis. This commonly occurs when a temporary ileostomy or colostomy is reversed after the original bowel condition has healed. General or colorectal surgeons typically perform the operation in a hospital operating room; specimen extraction may require an incision.
Report this code when the operative record supports laparoscopic closure with bowel resection and anastomosis. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 44227
- 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 RVU27.90 · 61%
- Practice expense (office) RVU11.39 · 25%
- Malpractice RVU6.20 · 14%
3.4K
Medicare services in 2024 · #2094 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.
44227 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
This is the open closure counterpart for resection and anastomosis when the enterostomy is other than colorectal. Use 44227 for the laparoscopic approach.
No office rate
This is the open closure counterpart for colorectal or Hartmann-type reversal with resection and anastomosis. Use 44227 when that closure is laparoscopic.
No office rate
This laparoscopic colectomy code describes an operation that creates an end colostomy and closes the distal bowel segment, not reversal of an existing enterostomy.
Compare 44227 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
Arkansas →
Office / nonfacility
Unavailable
Facility
$1365.33
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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 44227 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
5,377
- Code
- 44227
- Physician work
- 27.90
- Practice expense
- 11.39
- Malpractice
- 6.20
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 27.90 | × 1.000 | 27.9000 |
| Practice expense | 11.39 | × 0.859 | 9.7840 |
| Malpractice | 6.20 | × 0.515 | 3.1930 |
| Total RVUs | 40.8770 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$1365.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 27.9 | 1 |
| Practice expense | 11.39 | 0.859 |
| Malpractice | 6.2 | 0.515 |
(27.9 × 1 + 11.39 × 0.859 + 6.2 × 0.515) × $33.4009 = $1365.33
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.
44227 billing questions
When is 44227 appropriate instead of an open enterostomy-closure code?
Use 44227 when the closure is performed laparoscopically, with resection of the stoma-bearing bowel and anastomosis. Open procedures are represented by different closure codes.
How does 44227 differ from closure without resection?
The operative report must support removal of the stoma-bearing bowel segment and restoration of continuity with an anastomosis. Closure without resection is represented by a different code.
Can modifier 50 be appended for a stoma closure?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
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 other procedures are paid at 50% when performed in the same session.
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.
5,37444211,,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
5,37944300,,Open bowel to skin,A,,13.41,7.04,NA,7.04,,3.39,23.84,23.84,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38044310,,Ileostomy/jejunostomy,A,,17.15,7.97,NA,7.97,,3.85,28.97,28.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
1001182,CA,71,EL CENTRO,1.017,1.096,0.541