Billing code 44346: Colostomy revisionMedicare rate & RVUs in Guam
Reports operative revision of an existing colostomy performed with repair of a parastomal hernia, rather than revision alone or new colostomy creation.
CMS doesn’t publish an office rate for 44346 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 44346 covers
This code covers surgery that revises an existing colostomy and repairs the parastomal hernia around it. A colorectal or general surgeon may perform the operation when the hernia and stoma require operative correction, such as when the hernia interferes with pouching or causes symptoms. The service is generally performed in a hospital operating room, not as an office stoma adjustment.
Report the code when the operative work includes both colostomy revision and repair of the parastomal hernia. The operative report should document the existing colostomy, the hernia, and the work performed to revise the stoma and repair the hernia. Medicare assigns a 90-day global period, including the day-before preoperative visit and 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 multiple-procedure reduction. An assistant at surgery may be paid; 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.
44346 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,084.72 |
How the 44346 rate is calculated
Each of 44346’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 · 44346
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.14Practice expense 9.58Malpractice 4.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44346
44346 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44346
Colostomy revision
| 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 · 44346
Colostomy revision
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
44346 without 51 · national facility
$1,100.23
Colostomy revision
44346-51 · Second procedure: 50%
$550.12
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%).
44346 compared with similar codes
Compare codes
44346 vs 44340 vs 44345 vs 44312: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44340Colostomy revision
- 44340 is for simple colostomy revision, such as work at the skin or subcutaneous tissue. Choose 44346 when the operation also repairs a parastomal hernia.
- 44345Colostomy revision
- 44345 describes complicated colostomy revision involving intra-abdominal or peritoneal revision. 44346 identifies revision performed with repair of a parastomal hernia.
- 44312Ileostomy revision
- 44312 concerns revision of an ileostomy, not a colostomy. The ostomy type determines which code family applies.
44346 billing questions
How does this differ from 44340 or 44345?
Use 44346 when the colostomy revision is performed with repair of a parastomal hernia. Codes 44340 and 44345 describe colostomy revisions without that hernia-repair distinction.
Can the hernia repair be reported separately?
The defining work for 44346 includes repair of the parastomal hernia along with colostomy revision. The operative report should support both parts of that service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for the operation.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this code. Co-surgeon payment requires supporting documentation.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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