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CMS RVU26D · Effective 2026-10-01

44211 Proctocolectomy Medicare reimbursement rates in Connecticut

Reports laparoscopic removal of the colon and rectum with ileal pouch construction and connection to the anus, with a diverting loop ileostomy when performed. Compare 44211 office and facility rates across CMS payment localities in Connecticut.

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 44211 in Connecticut?

Connecticut 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

$2029.86

1 of 1 localities have a supported rate.

Payment area: Connecticut

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.

Find 44211 in your payment locality →

Colorectal surgery

About 44211: Laparoscopic restorative proctocolectomy with ileal pouch

Reports laparoscopic removal of the colon and rectum with ileal pouch construction and connection to the anus, with a diverting loop ileostomy when performed.

This laparoscopic restorative proctocolectomy removes the colon and rectum, forms an ileal reservoir, and connects it to the anus. Colorectal surgeons commonly perform it in an operating room for ulcerative colitis or familial adenomatous polyposis when ileoanal reconstruction is planned. A diverting loop ileostomy may be created as part of the operation.

Report 44211 when the completed procedure includes total colectomy with proctectomy, ileal pouch construction, and ileoanal anastomosis; the loop ileostomy, when performed, is included. The operative report should document the resection extent, pouch construction, anastomosis, and diversion. Medicare includes the day-before preoperative visit and related postoperative care through 90 days after surgery. When another procedure is 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. Report the combined operation as one procedure, not as paired-side services. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.

CMS billing rules for 44211

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 RVU36.15 · 63%
  • Practice expense (office) RVU16.36 · 28%
  • Malpractice RVU5.19 · 9%

31

Medicare services in 2024 · #5647 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.

44211 compared with similar codes

Office rates for Connecticut, from the same CMS release.

44210

Total colectomy

Laparoscopic, rectum retained

No office rate

44210 removes the colon without removing the rectum and may include ileostomy or ileoproctostomy. Choose 44211 when proctectomy and ileoanal pouch reconstruction are performed.

44212

Proctocolectomy

Ileoanal pouch with loop ileostomy

No office rate

44212 includes proctectomy with ileostomy but does not describe ileal pouch construction and ileoanal anastomosis. Those restorative steps distinguish 44211.

44207

Colectomy

Low pelvic anastomosis

No office rate

44207 describes a laparoscopic partial colectomy with a low pelvic anastomosis. It is not the code for total proctocolectomy with an ileal pouch.

44158

Colectomy

Ileoanal pouch reconstruction

No office rate

44158 describes the open approach to total proctocolectomy with ileoanal pouch reconstruction; 44211 is for the laparoscopic approach.

Compare 44211 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

Office and facility base rates · shared scale starting at $0

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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 44211 in Connecticut.

PPRRVU2026_Oct_nonQPP.csv

5,374

Code
44211
Physician work
36.15
Practice expense
16.36
Malpractice
5.19

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 44211 in Connecticut
ComponentRVULocality factorAdjusted
Physician work36.15× 1.02036.8730
Practice expense16.36× 1.07717.6197
Malpractice5.19× 1.2106.2799
Total RVUs60.7726
Conversion factor× 33.4009

Facility rate, Connecticut$2029.86

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work36.151.02
Practice expense16.361.077
Malpractice5.191.21

(36.15 × 1.02 + 16.36 × 1.077 + 5.19 × 1.21) × $33.4009 = $2029.86

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.

44211 billing questions

When should 44211 be chosen over 44212?

Use 44211 when the operation includes an ileal reservoir connected to the anus. Use 44212 for total proctocolectomy with an ileostomy when an ileoanal pouch reconstruction is not performed.

Is a diverting loop ileostomy separately reported?

The loop ileostomy, when performed as part of this operation, is included in 44211.

Can splenic flexure mobilization be reported separately?

Code 44213 is an add-on for qualifying laparoscopic splenic flexure mobilization performed with the primary colorectal procedure. Document the work performed and report it with the primary code.

What documentation supports reporting 44211?

The operative report should establish laparoscopic removal of the colon and rectum, ileal pouch construction, and ileoanal anastomosis, and state whether a loop ileostomy was created.

How should bilateral modifiers and the global period be handled?

Report the combined operation as one procedure rather than as right- and left-sided services. The 90-day global includes the day-before preoperative visit and related postoperative care.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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.

RVUs for 44211PPRRVU2026_Oct_nonQPP.csv, line 5,374 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)