Billing code 44320: ColostomyMedicare rate & RVUs in Nebraska
Report open creation of a colostomy or skin-level cecostomy to divert bowel contents, such as for obstruction, perforation, or planned fecal diversion.
CMS doesn’t publish an office rate for 44320 in Nebraska.
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 44320 covers
The surgeon brings a portion of colon through the abdominal wall and creates a stoma for fecal diversion, either as a temporary measure or for longer-term use. A skin-level cecostomy is another procedure represented by this code. Common situations include diversion for distal colorectal obstruction, perforation, or protection of a distal repair. The procedure is generally performed in an operating room by a general or colorectal surgeon.
Use this code for open creation; laparoscopic creation is represented by 44188. The operative report should identify the bowel segment and stoma created, the approach, and the clinical reason for diversion. When biopsy accompanies the colostomy or skin-level cecostomy, consider 44322. Medicare assigns a 90-day global period, including 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-surgeons require 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.
44320 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,003.55 |
How the 44320 rate is calculated
Each of 44320’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 · 44320
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.41Practice expense 9.68Malpractice 4.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44320
44320 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44320
Colostomy
| 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 · 44320
Colostomy
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
44320 without 51 · national facility
$1,121.94
Colostomy
44320-51 · Second procedure: 50%
$560.97
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%).
44320 compared with similar codes
Compare codes
44320 vs 44188 vs 44322 vs 44310 vs 44340: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44188Colostomy
- This code represents open creation. Use 44188 when the colostomy or skin-level cecostomy is created laparoscopically.
- 44322Colostomy
- Choose 44322 when biopsy accompanies creation of the colostomy or skin-level cecostomy; 44320 represents creation without that biopsy service.
- 44310Small-bowel stoma
- 44310 is for an ileostomy or jejunostomy, which diverts small-bowel contents; 44320 is for a colostomy or skin-level cecostomy.
- 44340Colostomy revision
- 44340 represents revision of an existing colostomy, not creation of a new colostomy.
44320 billing questions
When should 44320 be used instead of 44188?
Use 44320 for open creation of the colostomy or skin-level cecostomy. Code 44188 represents laparoscopic creation.
Does this code cover a small-bowel ostomy?
No. This code is for a colostomy or skin-level cecostomy; 44310 represents an ileostomy or jejunostomy.
What if biopsy is performed during the ostomy creation?
When biopsy accompanies the colostomy or skin-level cecostomy, use 44322 rather than reporting the creation as 44320.
Is routine postoperative care separately reported?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
How is 44320 handled with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is not appropriate for this code.
Can an assistant or co-surgeon be reported?
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 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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