No office rate
44205 includes terminal ileum removal and an ileocolic connection. Choose 44204 when the colectomy has a different anastomosis and does not match that anatomy.
On this page
CMS RVU26D · Effective 2026-10-01
44205 Colectomy Medicare reimbursement rates in Pennsylvania
Laparoscopic removal of a colonic segment with terminal ileum and ileocolic reconstruction, reported when the operative resection includes this specific anatomy. Compare 44205 office and facility rates across CMS payment localities in Pennsylvania.
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 44205 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1191.21–$1283.49
2 of 2 localities have a supported rate.
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.
Colorectal surgery
About 44205: Laparoscopic ileocolic colectomy
Laparoscopic removal of a colonic segment with terminal ileum and ileocolic reconstruction, reported when the operative resection includes this specific anatomy.
This code describes laparoscopic resection of part of the colon that also removes the terminal ileum, followed by joining the remaining small bowel to the colon. It commonly represents a right-sided resection for colon cancer, Crohn disease, or another condition affecting the ileocecal region. A colorectal or general surgeon typically performs the operation in a hospital or other surgical facility. The operative report should establish the laparoscopic approach, the bowel removed, and the reconstruction performed.
Report this code when the documented resection includes terminal ileum and the ileocolic connection; a partial colectomy with a different reconstruction may fall under a neighboring code. CMS assigns a 90-day major-surgery 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 others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 44205
- 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 RVU22.38 · 61%
- Practice expense (office) RVU9.55 · 26%
- Malpractice RVU4.78 · 13%
13.4K
Medicare services in 2024 · #1316 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.
44205 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
44206 describes a partial colectomy with a stoma. This code is for the resection with ileocolic reconstruction, not the stoma configuration.
No office rate
44160 describes the corresponding open operation. Use 44205 for the laparoscopic approach when its terminal-ileum and ileocolic-reconstruction details are met.
Compare 44205 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1283.49
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1191.21
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44205 billing questions
How is this distinguished from 44204?
Use 44205 when the resection includes terminal ileum and the reconstruction joins small bowel to colon. A partial colectomy with a different anastomosis may fit 44204 instead.
Is the ileocolic connection separately reported?
The connection is part of the resection service described by this code; it is not a separate service solely because the surgeon documents the anastomosis.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used to indicate bilateral surgery.
What supports reporting 44205?
The operative report should document the laparoscopic approach, removal of terminal ileum along with colon, and the ileocolic reconstruction.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and other procedures at 50%. An assistant may be paid; co-surgeons require supporting documentation.
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.
5,36644202,,Lap enterectomy,A,,22.81,10.19,NA,10.19,,5.59,38.59,38.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36744203,,Lap resect s/intestine addl,A,,4.33,1.07,NA,1.07,,1.07,6.47,6.47,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36844204,,Laparo partial colectomy,A,,25.76,10.80,NA,10.80,,5.75,42.31,42.31,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36944205,,Lap colectomy part w/ileum,A,,22.38,9.55,NA,9.55,,4.78,36.71,36.71,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37044206,,Lap part colectomy w/stoma,A,,29.05,12.31,NA,12.31,,6.56,47.92,47.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37144207,,L colectomy/coloproctostomy,A,,31.12,11.90,NA,11.90,,6.36,49.38,49.38,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37244208,,L colectomy/coloproctostomy,A,,33.14,14.10,NA,14.10,,6.71,53.95,53.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00