Billing code 44156: ColectomyMedicare rate & RVUs in Guam
Reports open removal of the entire colon and rectum with creation of a continent ileostomy, typically for extensive colonic disease requiring this reconstruction.
CMS doesn’t publish an office rate for 44156 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 44156 covers
A colorectal surgeon removes the entire colon and rectum through an abdominal operation and forms a continent ileostomy from the small bowel. The internal reservoir connects to a catheterizable abdominal stoma, allowing the patient to empty it by catheter rather than use a conventional external ileostomy appliance. This reconstruction may be performed for extensive disease such as ulcerative colitis or familial adenomatous polyposis when proctectomy and a continent diversion are planned.
Report this code when the operative record supports total colectomy, proctectomy, and creation of the continent ileostomy; a conventional end ileostomy or ileoanal reconstruction represents a different operation. The service has a 90-day global period, including 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 the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
44156 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $2,092.52 |
How the 44156 rate is calculated
Each of 44156’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 44156
RVUs × geographic indexes × conversion factor
Work36.48
36.48 RVUs× 1.000 GPCI
Practice expense18.03
18.03 RVUs× 1.000 GPCI
Malpractice9.79
9.79 RVUs× 1.000 GPCI
Adjusted RVUs
64.3000
Conversion factor
$33.4009
Medicare rate
$2,147.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44156
44156 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44156
Colectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 44156
Colectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44156 without 51 · national facility
$2,147.68
Colectomy
44156-51 · Second procedure: 50%
$1,073.84
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
44156 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 44155Colectomy
- Choose 44156 for a continent, catheterizable ileostomy after total colectomy and proctectomy; 44155 describes the conventional ileostomy reconstruction.
- 44151Total colectomy
- Both describe a continent ileostomy with total colectomy, but 44151 does not include proctectomy. The operative report must establish whether the rectum was removed.
- 44157Proctocolectomy
- 44157 describes ileoanal anastomosis after total colectomy and proctectomy. Use 44156 when the reconstruction is a continent ileostomy through an abdominal stoma.
- 44158Colectomy
- 44158 includes an ileal reservoir for ileoanal reconstruction; 44156 creates a continent abdominal ileostomy rather than an ileoanal connection.
44156 billing questions
How does this differ from 44155?
Both include total colectomy and proctectomy. Code 44156 includes creation of a continent ileostomy; 44155 describes a conventional ileostomy.
When is 44151 a closer match?
44151 describes total colectomy with a continent ileostomy without proctectomy. Use 44156 when the rectum is also removed.
Does this code include the continent ileostomy?
Yes. Creation of the continent ileostomy is part of the operation represented by this code, alongside total colectomy and proctectomy.
How does 44156 differ from 44157 or 44158?
44157 and 44158 describe ileoanal reconstruction after proctectomy, with 44158 including creation of an ileal reservoir. Code 44156 instead creates a continent abdominal ileostomy.
What documentation supports reporting 44156?
The operative report should establish removal of the entire colon and rectum and formation of a continent, catheterizable ileostomy. It should distinguish this reconstruction from a conventional ileostomy or ileoanal connection.
How are other same-session procedures and surgical assistants handled?
Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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