No office rate
Choose 44156 for a continent, catheterizable ileostomy after total colectomy and proctectomy; 44155 describes the conventional ileostomy reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
44156 Colectomy Medicare reimbursement rates in Iowa
Reports open removal of the entire colon and rectum with creation of a continent ileostomy, typically for extensive colonic disease requiring this reconstruction. Compare 44156 office and facility rates across CMS payment localities in Iowa.
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 44156 in Iowa?
Iowa 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
$1899.31
1 of 1 localities have a supported rate.
Payment area: Iowa
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 44156: Total colectomy with proctectomy and continent ileostomy
Reports open removal of the entire colon and rectum with creation of a continent ileostomy, typically for extensive colonic disease requiring this reconstruction.
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.
CMS billing rules for 44156
- 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 RVU36.48 · 57%
- Practice expense (office) RVU18.03 · 28%
- Malpractice RVU9.79 · 15%
14
Medicare services in 2024 · #6103 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.
44156 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Both describe a continent ileostomy with total colectomy, but 44151 does not include proctectomy. The operative report must establish whether the rectum was removed.
No office rate
44157 describes ileoanal anastomosis after total colectomy and proctectomy. Use 44156 when the reconstruction is a continent ileostomy through an abdominal stoma.
No office rate
44158 includes an ileal reservoir for ileoanal reconstruction; 44156 creates a continent abdominal ileostomy rather than an ileoanal connection.
Compare 44156 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1899.31
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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 44156 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,358
- Code
- 44156
- Physician work
- 36.48
- Practice expense
- 18.03
- Malpractice
- 9.79
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 36.48 | × 1.000 | 36.4800 |
| Practice expense | 18.03 | × 0.915 | 16.4975 |
| Malpractice | 9.79 | × 0.397 | 3.8866 |
| Total RVUs | 56.8641 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1899.31
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 36.48 | 1 |
| Practice expense | 18.03 | 0.915 |
| Malpractice | 9.79 | 0.397 |
(36.48 × 1 + 18.03 × 0.915 + 9.79 × 0.397) × $33.4009 = $1899.31
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.
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 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.
5,35544150,,Removal of colon,A,,29.43,15.59,NA,15.59,,6.79,51.81,51.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,35644151,,Removal of colon/ileostomy,A,,34.05,17.03,NA,17.03,,9.13,60.21,60.21,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,35744155,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136