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CMS RVU26D · Effective 2026-10-01

44212 Proctocolectomy Medicare reimbursement rates in Ohio

Reports laparoscopic removal of the colon and rectum with ileal pouch construction, ileoanal connection, and a diverting loop ileostomy. Compare 44212 office and facility rates across CMS payment localities in Ohio.

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 44212 in Ohio?

Ohio 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

$1817.19

1 of 1 localities have a supported rate.

Payment area: Ohio

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.

Find 44212 in your payment locality →

Digestive surgery

About 44212: Laparoscopic total proctocolectomy with pouch

Reports laparoscopic removal of the colon and rectum with ileal pouch construction, ileoanal connection, and a diverting loop ileostomy.

A colorectal surgeon performs this operation laparoscopically to remove the entire colon and rectum, construct a reservoir from the ileum, connect it to the anus, and create a temporary loop ileostomy to divert stool. It is commonly performed for conditions such as ulcerative colitis or familial adenomatous polyposis when removal of the colon and rectum with an ileal pouch is planned. The service is typically performed in a hospital operating room.

Select this code when the operative report supports the laparoscopic approach, total colon and rectum removal, ileal pouch reconstruction, and loop ileostomy. The day-before preoperative visit and 90 days of related postoperative care are included in its 90-day global period. 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 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 44212

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 RVU33.72 · 60%
  • Practice expense (office) RVU16.01 · 29%
  • Malpractice RVU6.02 · 11%

160

Medicare services in 2024 · #4512 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.

44212 compared with similar codes

Office rates for Ohio, from the same CMS release.

44210

Total colectomy

Laparoscopic, rectum retained

No office rate

44210 describes total colectomy without proctectomy. This code includes removal of the rectum and ileal pouch reconstruction.

44211

Proctocolectomy

Ileoanal pouch reconstruction

No office rate

44211 includes total colectomy and proctectomy with ileostomy, but not the ileal pouch and ileoanal connection described here.

44204

Partial colectomy

Laparoscopic with anastomosis

No office rate

44204 is for laparoscopic partial colectomy, not removal of the entire colon and rectum with pouch reconstruction.

Compare 44212 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

Office and facility base rates · shared scale starting at $0

  • Ohio →

    Office / nonfacility

    Unavailable

    Facility

    $1817.19

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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 44212 in Ohio.

PPRRVU2026_Oct_nonQPP.csv

5,375

Code
44212
Physician work
33.72
Practice expense
16.01
Malpractice
6.02

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Facility calculation for 44212 in Ohio
ComponentRVULocality factorAdjusted
Physician work33.72× 1.00033.7200
Practice expense16.01× 0.91314.6171
Malpractice6.02× 1.0086.0682
Total RVUs54.4053
Conversion factor× 33.4009

Facility rate, Ohio$1817.19

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work33.721
Practice expense16.010.913
Malpractice6.021.008

(33.72 × 1 + 16.01 × 0.913 + 6.02 × 1.008) × $33.4009 = $1817.19

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.

44212 billing questions

How does this differ from a total proctocolectomy without a pouch?

This code describes ileal pouch construction with an ileoanal connection and diverting loop ileostomy. Use a different code when the operative reconstruction does not include those elements.

Is the ileal pouch separately reported?

The pouch construction is part of this operation when performed as described. The operative report should document the reconstruction and ileoanal connection.

What documentation supports reporting this code?

Document the laparoscopic approach, removal of the entire colon and rectum, ileal reservoir construction, ileoanal connection, and loop ileostomy.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. 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 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.

RVUs for 44212PPRRVU2026_Oct_nonQPP.csv, line 5,375 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet