Billing code 44620: Stoma closureMedicare rate & RVUs in Illinois
Reports surgical takedown of a small- or large-intestinal stoma when restoring bowel continuity does not require the resection-and-anastomosis work of related codes.
CMS doesn’t publish an office rate for 44620 in Illinois.
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 44620 covers
A surgeon closes a previously created intestinal opening, such as an ileostomy or colostomy, and restores continuity between the bowel and the distal intestine. The procedure is generally performed in an operating room, often in a hospital, after the original condition has resolved or the temporary diversion is no longer needed. This code distinguishes a stoma closure from closure that includes intestinal resection and anastomosis.
Select the code based on the documented operative work, including the stoma site and whether bowel resection with anastomosis was performed. The operative report should identify the enterostomy being closed and describe the closure and restoration of continuity. This major surgery code 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% reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be available; 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.
Where 44620 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $939.90 |
| East St. Louis | Unavailable | $888.32 |
| Rest Of Illinois | Unavailable | $840.90 |
| Suburban Chicago | Unavailable | $891.91 |
How the 44620 rate is calculated
Each of 44620’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 · 44620
RVUs × geographic indexes × conversion factor
Work14.07
14.07 RVUs× 1.000 GPCI
Practice expense6.96
6.96 RVUs× 1.000 GPCI
Malpractice3.04
3.04 RVUs× 1.000 GPCI
Adjusted RVUs
24.0700
Conversion factor
$33.4009
Medicare rate
$803.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44620
44620 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44620
Stoma closure
| 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 · 44620
Stoma closure
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
44620 without 51 · national facility
$803.96
Stoma closure
44620-51 · Second procedure: 50%
$401.98
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%).
44620 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 44625Ostomy reversal
- 44625 includes enterostomy closure with resection and anastomosis. Use 44620 when the operative work does not include that resection-and-anastomosis service.
- 44626Enterostomy closure
- 44626 specifies resection with colorectal anastomosis during enterostomy closure. The operative report must support that distinction.
- 44604Colon repair
- 44604 describes suture repair of the large intestine, such as repair of a bowel opening, rather than closure of a previously created stoma.
- 44640Fistula repair
- 44640 addresses repair of a bowel-to-skin fistula. A planned enterostomy takedown is reported with the applicable closure code instead.
44620 billing questions
How is 44620 different from 44625?
Use 44620 for enterostomy closure without the resection-and-anastomosis work described by 44625. Choose based on the actual operative report, not just the fact that bowel continuity was restored.
When does 44626 apply instead?
44626 is a related closure code that specifies resection with colorectal anastomosis. Use it when that documented operative work is performed.
What documentation supports 44620?
The operative report should identify the stoma and bowel site, describe its takedown and closure, and support that the work does not meet the resection-and-anastomosis distinctions of the related codes.
How does the global period affect billing?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 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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