No office rate
Both codes address a bowel-bladder fistula. Choose 44661 when the repair includes resection of intestine, bladder tissue, or both; choose 44660 when it does not.
On this page
CMS RVU26D · Effective 2026-10-01
44661 Fistula repair Medicare reimbursement rates in Massachusetts
Reports operative repair of a bowel-to-bladder fistula when the surgeon resects involved intestine, bladder tissue, or both as part of treatment. Compare 44661 office and facility rates across CMS payment localities in Massachusetts.
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 44661 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1406.42–$1493.16
2 of 2 localities have a supported rate.
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.
Digestive surgery
About 44661: Bowel-bladder fistula repair with resection
Reports operative repair of a bowel-to-bladder fistula when the surgeon resects involved intestine, bladder tissue, or both as part of treatment.
This service treats an abnormal connection between the intestine and bladder when repair requires removal of involved bowel or bladder tissue. A colorectal or general surgeon commonly performs the intestinal portion, sometimes with a urologist participating in bladder repair. Typical cases include a colovesical fistula associated with diverticular disease, inflammatory bowel disease, or a tumor. The operation may involve separating the organs, removing the diseased segment, and repairing the remaining tissue.
Select this code when the operative report documents fistula repair with resection of intestine, bladder, or both; use the non-resection sibling when repair is completed without either resection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 44661
- 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 RVU26.67 · 63%
- Practice expense (office) RVU9.85 · 23%
- Malpractice RVU5.82 · 14%
500
Medicare services in 2024 · #3563 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.
44661 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
This code is for a bowel fistula repair without the bowel-to-bladder connection that defines 44661.
No office rate
This code addresses a bowel-to-skin fistula. Use 44661 for a tract connecting bowel and bladder when the repair includes resection.
Compare 44661 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$1493.16
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$1406.42
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44661 billing questions
How does 44661 differ from 44660?
Use 44661 when the fistula repair includes resection of involved intestine, bladder tissue, or both. Use 44660 when the repair is performed without either resection.
Can the bowel or bladder resection be billed separately?
The resection that is part of the fistula repair is included in the service represented by 44661. Do not separately report that same resection as an independent procedure.
What should the operative report document?
Document the bowel-to-bladder connection, the repair performed, and whether intestine, bladder tissue, or both were resected. The report should make clear that resection was part of treating the fistula.
Should modifier 50 be used?
No. Modifier 50 is inappropriate for this repair; the anatomy is not reported as a bilateral service.
How are other procedures in the same session paid?
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. The 90-day global period includes related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. 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.
5,43444640,,Repair bowel-skin fistula,A,,23.60,9.41,NA,9.41,,5.43,38.44,38.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43544650,,Repair bowel fistula,A,,24.49,9.63,NA,9.63,,5.50,39.62,39.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43644660,,Repair bowel-bladder fistula,A,,23.31,8.75,NA,8.75,,4.36,36.42,36.42,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43744661,,Repair bowel-bladder fistula,A,,26.67,9.85,NA,9.85,,5.82,42.34,42.34,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43844680,,Surgical revision intestine,A,,17.51,8.02,NA,8.02,,4.69,30.22,30.22,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43944700,,Suspend bowel w/prosthesis,A,,17.04,7.30,NA,7.30,,3.10,27.44,27.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,44044701,,Intraop colon lavage add-on,A,,3.02,0.73,NA,0.73,,0.81,4.56,4.56,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00