No office rate
Use 44187 for laparoscopic ileostomy or jejunostomy creation; 44188 creates a colonic stoma.
On this page
CMS RVU26D · Effective 2026-10-01
44188 Colostomy Medicare reimbursement rates in Missouri
Report laparoscopic creation of a colonic stoma to divert intestinal contents, such as for obstruction, perforation, or protection of distal bowel. Compare 44188 office and facility rates across CMS payment localities in Missouri.
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 44188 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1085.10–$1122.22
3 of 3 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.
Where 44188 pays more and less in Missouri
Digestive surgery
About 44188: Laparoscopic colostomy creation
Report laparoscopic creation of a colonic stoma to divert intestinal contents, such as for obstruction, perforation, or protection of distal bowel.
The surgeon uses laparoscopic access to bring a portion of the colon to the abdominal wall and form a stoma. Colorectal and general surgeons commonly perform this operation in a hospital operating room to divert stool around distal obstruction, injury, inflammation, or a healing colorectal repair. The stoma may be intended as temporary diversion or long-term fecal diversion; the code identifies colonic rather than small-bowel ostomy creation.
Select 44188 when laparoscopic colostomy creation is the service performed, rather than a more extensive bowel-resection procedure that includes ostomy construction. The operative report should identify the laparoscopic approach, the colonic stoma created, and the clinical reason for diversion. Related preoperative care on the day before surgery and 90 days of postoperative care are included in the 90-day global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 44188
- 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 RVU18.87 · 55%
- Practice expense (office) RVU11.04 · 32%
- Malpractice RVU4.21 · 12%
4.4K
Medicare services in 2024 · #1959 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.
44188 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
44320 describes open colostomy creation. Choose 44188 when the stoma is created laparoscopically.
No office rate
44206 includes laparoscopic partial colectomy with end colostomy. It is the more appropriate service when that bowel resection and diversion are performed together.
Compare 44188 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$1113.91
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1122.22
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$1085.10
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44188 billing questions
How does 44188 differ from a laparoscopic ileostomy?
44188 is for creating a colonic stoma. Use 44187 for laparoscopic ileostomy or jejunostomy creation.
Can 44188 be reported separately with a colectomy?
When a colectomy code describes the resection and associated ostomy construction, report that comprehensive procedure rather than separately reporting 44188 for the stoma.
What is the difference between 44188 and 44320?
Both describe colostomy creation, but 44188 is laparoscopic and 44320 is the open approach.
What documentation supports 44188?
The operative report should establish laparoscopic access, creation of a colonic stoma, and the indication for diversion. It should also make clear whether bowel resection was part of the operation.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be available for 44188. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,36244180,,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
5,36444187,,Lap ileo/jejuno-stomy,A,,16.97,10.31,NA,10.31,,3.40,30.68,30.68,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36544188,,Lap colostomy,A,,18.87,11.04,NA,11.04,,4.21,34.12,34.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36644202,,Lap enterectomy,A,,22.81,10.19,NA,10.19,,5.59,38.59,38.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36744203,,Lap resect s/intestine addl,A,,4.33,1.07,NA,1.07,,1.07,6.47,6.47,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36844204,,Laparo partial colectomy,A,,25.76,10.80,NA,10.80,,5.75,42.31,42.31,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00