No office rate
Choose 44660 for fistula closure without intestinal resection. Consider 44661 when the operative service includes resection of intestine.
On this page
CMS RVU26D · Effective 2026-10-01
44660 Bowel-bladder fistula repair Medicare reimbursement rates in Oklahoma
Reports operative closure of an abnormal connection between intestine and bladder when the repair is performed without intestinal resection. Compare 44660 office and facility rates across CMS payment localities in Oklahoma.
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 44660 in Oklahoma?
Oklahoma 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
$1152.71
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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.
Intestinal surgery
About 44660: Enterovesical fistula repair without bowel resection
Reports operative closure of an abnormal connection between intestine and bladder when the repair is performed without intestinal resection.
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.
CMS billing rules for 44660
- 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 RVU23.31 · 64%
- Practice expense (office) RVU8.75 · 24%
- Malpractice RVU4.36 · 12%
186
Medicare services in 2024 · #4381 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.
44660 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
This code addresses a bowel-bladder connection. Code 44650 is for a different intestinal fistula repair, so the documented destination of the tract matters.
No office rate
44640 concerns a bowel-to-skin fistula; 44660 is for a connection between bowel and bladder.
No office rate
44604 describes suturing large intestine, not repair of a bowel-bladder fistula. Select based on the operation actually performed.
Compare 44660 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$1152.71
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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 44660 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
5,436
- Code
- 44660
- Physician work
- 23.31
- Practice expense
- 8.75
- Malpractice
- 4.36
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.31 | × 1.000 | 23.3100 |
| Practice expense | 8.75 | × 0.893 | 7.8137 |
| Malpractice | 4.36 | × 0.777 | 3.3877 |
| Total RVUs | 34.5115 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$1152.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.31 | 1 |
| Practice expense | 8.75 | 0.893 |
| Malpractice | 4.36 | 0.777 |
(23.31 × 1 + 8.75 × 0.893 + 4.36 × 0.777) × $33.4009 = $1152.71
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.
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 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.
5,43344626,,Repair bowel opening,A,,27.20,10.18,NA,10.18,,6.22,43.60,43.60,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43444640,,Repair bowel-skin fistula,A,,23.60,9.41,NA,9.41,,5.43,38.44,38.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43544650,,Repair bowel fistula,A,,24.49,9.63,NA,9.63,,5.50,39.62,39.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43644660,,Repair bowel-bladder fistula,A,,23.31,8.75,NA,8.75,,4.36,36.42,36.42,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43744661,,Repair bowel-bladder fistula,A,,26.67,9.85,NA,9.85,,5.82,42.34,42.34,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43844680,,Surgical revision intestine,A,,17.51,8.02,NA,8.02,,4.69,30.22,30.22,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,43944700,,Suspend bowel w/prosthesis,A,,17.04,7.30,NA,7.30,,3.10,27.44,27.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193