Billing code 44660: Bowel-bladder fistula repairMedicare rate & RVUs in Ohio
Reports operative closure of an abnormal connection between intestine and bladder when the repair is performed without intestinal resection.
CMS doesn’t publish an office rate for 44660 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 44660 covers
This service treats an abnormal passage between the bowel and urinary bladder, often a colovesical fistula associated with diverticular disease. A colorectal or general surgeon typically operates in a hospital or other surgical facility, separating the involved organs and closing the fistula. A urologist may participate when the bladder portion requires additional operative attention. The code distinguishes repair without bowel resection from the related service that includes intestinal resection.
Report the code when the operative record supports closure of the bowel-bladder tract without resecting intestine; document the fistula’s location, operative steps, and whether bowel was removed. This is major surgery with a 90-day global period, including the day-before preoperative visit 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 a 50% reduction. Bilateral adjustment does not apply because modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
44660 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,192.20 |
How the 44660 rate is calculated
Each of 44660’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 · 44660
RVUs × geographic indexes × conversion factor
Work23.31
23.31 RVUs× 1.000 GPCI
Practice expense8.75
8.75 RVUs× 1.000 GPCI
Malpractice4.36
4.36 RVUs× 1.000 GPCI
Adjusted RVUs
36.4200
Conversion factor
$33.4009
Medicare rate
$1,216.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44660
44660 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44660
Bowel-bladder fistula repair
| 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 · 44660
Bowel-bladder fistula repair
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
44660 without 51 · national facility
$1,216.46
Bowel-bladder fistula repair
44660-51 · Second procedure: 50%
$608.23
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%).
44660 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 44661Fistula repair
- Choose 44660 for fistula closure without intestinal resection. Consider 44661 when the operative service includes resection of intestine.
- 44650Fistula repair
- This code addresses a bowel-bladder connection. Code 44650 is for a different intestinal fistula repair, so the documented destination of the tract matters.
- 44640Fistula repair
- 44640 concerns a bowel-to-skin fistula; 44660 is for a connection between bowel and bladder.
- 44604Colon repair
- 44604 describes suturing large intestine, not repair of a bowel-bladder fistula. Select based on the operation actually performed.
44660 billing questions
When should 44660 be selected instead of 44661?
Use 44660 when the fistula is repaired without intestinal resection. If the operation includes resection of intestine, compare the documentation with 44661.
Can modifier 50 be reported for a fistula involving both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is 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.
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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