No office rate
Both involve total colectomy, proctectomy, and an ileoanal connection. Choose 44158 when the surgeon creates an ileal reservoir; 44157 describes the procedure without one.
On this page
CMS RVU26D · Effective 2026-10-01
44158 Colectomy Medicare reimbursement rates in Idaho
Reports total colon and rectum removal with ileoanal pouch reconstruction, typically for restorative surgery in ulcerative colitis or familial adenomatous polyposis. Compare 44158 office and facility rates across CMS payment localities in Idaho.
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 44158 in Idaho?
Idaho 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
$1876.51
1 of 1 localities have a supported rate.
Payment area: Idaho
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 44158: Total proctocolectomy with ileal pouch
Reports total colon and rectum removal with ileoanal pouch reconstruction, typically for restorative surgery in ulcerative colitis or familial adenomatous polyposis.
This code describes an abdominal operation removing the colon and rectum, then connecting an ileal reservoir to the anus to restore intestinal continuity. The surgeon forms the reservoir from the patient’s ileum; a temporary loop ileostomy may also be created. Colorectal and general surgeons commonly perform this restorative procedure for conditions such as ulcerative colitis or familial adenomatous polyposis when an ileal pouch is planned.
Select the code when the operative report supports total colectomy, proctectomy, ileoanal anastomosis, and creation of the pouch. The pouch reconstruction distinguishes it from the related ileoanal procedure without a reservoir. The 90-day global period includes the preoperative day and 90 days of related postoperative care. For multiple procedures in one session, 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, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.
CMS billing rules for 44158
- 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 RVU35.78 · 57%
- Practice expense (office) RVU17.25 · 28%
- Malpractice RVU9.58 · 15%
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.
44158 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
This code is for restorative ileoanal pouch surgery. 44155 describes total colectomy and proctectomy with an ileostomy rather than pouch reconstruction.
No office rate
44150 is total abdominal colectomy without proctectomy. Use 44158 when the rectum is also removed and an ileal pouch is connected to the anus.
Compare 44158 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
Idaho →
Office / nonfacility
Unavailable
Facility
$1876.51
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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 44158 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
5,360
- Code
- 44158
- Physician work
- 35.78
- Practice expense
- 17.25
- Malpractice
- 9.58
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.78 | × 1.000 | 35.7800 |
| Practice expense | 17.25 | × 0.920 | 15.8700 |
| Malpractice | 9.58 | × 0.473 | 4.5313 |
| Total RVUs | 56.1813 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$1876.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.78 | 1 |
| Practice expense | 17.25 | 0.92 |
| Malpractice | 9.58 | 0.473 |
(35.78 × 1 + 17.25 × 0.92 + 9.58 × 0.473) × $33.4009 = $1876.51
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.
44158 billing questions
How does this differ from 44157?
44158 includes creation of an ileal reservoir, such as a pouch, for the ileoanal connection. Use 44157 when the documented operation includes ileoanal anastomosis without that reservoir.
Is a temporary loop ileostomy included?
A loop ileostomy may be part of the pouch procedure. The code encompasses it when performed; do not report it separately as though it were an unrelated service.
What documentation supports selecting this code?
The operative report should establish removal of the colon and rectum, construction of an ileal reservoir, and connection of that reservoir to the anus.
Can modifier 50 be used?
No. Bilateral adjustment is inappropriate for this procedure and anatomy.
How are assistants and co-surgeons handled?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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.
5,35744155,,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
5,36344186,,Lap jejunostomy,A,,10.12,6.00,NA,6.00,,2.59,18.71,18.71,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772