Billing code 44158: ColectomyMedicare rate & RVUs in Ohio
Reports total colon and rectum removal with ileoanal pouch reconstruction, typically for restorative surgery in ulcerative colitis or familial adenomatous polyposis.
CMS doesn’t publish an office rate for 44158 in Ohio.
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 44158 covers
This code describes an abdominal operation removing the colon and rectum, then connecting an ileal reservoir to the anus to restore intestinal continuity. The surgeon forms the reservoir from the patient’s ileum; a temporary loop ileostomy may also be created. Colorectal and general surgeons commonly perform this restorative procedure for conditions such as ulcerative colitis or familial adenomatous polyposis when an ileal pouch is planned.
Select the code when the operative report supports total colectomy, proctectomy, ileoanal anastomosis, and creation of the pouch. The pouch reconstruction distinguishes it from the related ileoanal procedure without a reservoir. The 90-day global period includes the preoperative day and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.
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.
44158 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $2,043.66 |
How the 44158 rate is calculated
Each of 44158’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 · 44158
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 35.78Practice expense 17.25Malpractice 9.58
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44158
44158 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44158
Colectomy
| 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 · 44158
Colectomy
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
44158 without 51 · national facility
$2,091.23
Colectomy
44158-51 · Second procedure: 50%
$1,045.62
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%).
44158 compared with similar codes
Compare codes
44158 vs 44157 vs 44155 vs 44150: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44157Proctocolectomy
- Both involve total colectomy, proctectomy, and an ileoanal connection. Choose 44158 when the surgeon creates an ileal reservoir; 44157 describes the procedure without one.
- 44155Colectomy
- This code is for restorative ileoanal pouch surgery. 44155 describes total colectomy and proctectomy with an ileostomy rather than pouch reconstruction.
- 44150Total colectomy
- 44150 is total abdominal colectomy without proctectomy. Use 44158 when the rectum is also removed and an ileal pouch is connected to the anus.
44158 billing questions
How does this differ from 44157?
44158 includes creation of an ileal reservoir, such as a pouch, for the ileoanal connection. Use 44157 when the documented operation includes ileoanal anastomosis without that reservoir.
Is a temporary loop ileostomy included?
A loop ileostomy may be part of the pouch procedure. The code encompasses it when performed; do not report it separately as though it were an unrelated service.
What documentation supports selecting this code?
The operative report should establish removal of the colon and rectum, construction of an ileal reservoir, and connection of that reservoir to the anus.
Can modifier 50 be used?
No. Bilateral adjustment is inappropriate for this procedure and anatomy.
How are assistants and co-surgeons handled?
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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