Billing code 44146: Partial colectomyMedicare rate & RVUs in Oklahoma
Open partial colon resection with a low pelvic connection to the rectum and creation of a colostomy is reported for selected colorectal conditions.
CMS doesn’t publish an office rate for 44146 in Oklahoma.
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 44146 covers
This code represents an open operation removing part of the colon, joining the remaining colon to the rectum low in the pelvis, and creating a colostomy. General or colorectal surgeons may perform it in a hospital operating room for conditions such as rectosigmoid cancer or complicated diverticular disease when resection and a low pelvic anastomosis are performed along with a colostomy. The operative report should establish the bowel removed, the low pelvic connection, and the colostomy created.
Report this code when all three elements are performed; a partial colectomy with a low pelvic anastomosis but no colostomy is a different service. The resection, anastomosis, and colostomy are represented together rather than as separate component procedures. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 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.
44146 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $1,826.55 |
How the 44146 rate is calculated
Each of 44146’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 · 44146
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 34.42Practice expense 15.82Malpractice 7.90
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44146
44146 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44146
Partial 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 · 44146
Partial 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
44146 without 51 · national facility
$1,941.93
Partial colectomy
44146-51 · Second procedure: 50%
$970.97
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%).
44146 compared with similar codes
Compare codes
44146 vs 44145 vs 44140 vs 44143 vs 44147: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44145Partial colectomy
- Choose 44146 when the operation includes both the low pelvic anastomosis and a colostomy. 44145 describes the low pelvic anastomosis without that colostomy.
- 44140Partial colectomy
- 44140 is a partial colectomy with anastomosis, but it does not specify the low pelvic coloproctostomy and colostomy combination represented by 44146.
- 44143Partial colectomy
- 44143 describes an end colostomy with closure of the distal bowel. Use 44146 when the colon is connected to the rectum low in the pelvis and a colostomy is also created.
- 44147Partial colectomy
- 44147 identifies a partial colectomy performed through abdominal and transanal approaches; 44146 identifies the low pelvic anastomosis with colostomy combination.
44146 billing questions
How does this differ from 44145?
Both involve a partial colectomy with a low pelvic connection to the rectum. This code also includes creation of a colostomy; 44145 is the relevant sibling when no colostomy is created.
Can the colostomy be billed separately from this procedure?
The colostomy is part of the service represented by this code. The operative documentation should show that it was created as part of the same operation.
What should the operative report document?
Document the colon resected, the low pelvic anastomosis to the rectum, and the colostomy. Those details distinguish this service from other partial colectomy procedures.
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 made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What care is included in the global period?
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 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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