No office rate
This code represents open creation. Use 44188 when the colostomy or skin-level cecostomy is created laparoscopically.
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CMS RVU26D · Effective 2026-10-01
44320 Colostomy Medicare reimbursement rates in Pennsylvania
Report open creation of a colostomy or skin-level cecostomy to divert bowel contents, such as for obstruction, perforation, or planned fecal diversion. Compare 44320 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 44320 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
$1087.16–$1175.87
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.
Digestive system surgery
About 44320: Open colostomy creation
Report open creation of a colostomy or skin-level cecostomy to divert bowel contents, such as for obstruction, perforation, or planned fecal diversion.
The surgeon brings a portion of colon through the abdominal wall and creates a stoma for fecal diversion, either as a temporary measure or for longer-term use. A skin-level cecostomy is another procedure represented by this code. Common situations include diversion for distal colorectal obstruction, perforation, or protection of a distal repair. The procedure is generally performed in an operating room by a general or colorectal surgeon.
Use this code for open creation; laparoscopic creation is represented by 44188. The operative report should identify the bowel segment and stoma created, the approach, and the clinical reason for diversion. When biopsy accompanies the colostomy or skin-level cecostomy, consider 44322. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 44320
- 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 RVU19.41 · 58%
- Practice expense (office) RVU9.68 · 29%
- Malpractice RVU4.50 · 13%
3.2K
Medicare services in 2024 · #2128 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.
44320 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Choose 44322 when biopsy accompanies creation of the colostomy or skin-level cecostomy; 44320 represents creation without that biopsy service.
No office rate
44310 is for an ileostomy or jejunostomy, which diverts small-bowel contents; 44320 is for a colostomy or skin-level cecostomy.
No office rate
44340 represents revision of an existing colostomy, not creation of a new colostomy.
Compare 44320 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
$1175.87
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1087.16
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44320 billing questions
When should 44320 be used instead of 44188?
Use 44320 for open creation of the colostomy or skin-level cecostomy. Code 44188 represents laparoscopic creation.
Does this code cover a small-bowel ostomy?
No. This code is for a colostomy or skin-level cecostomy; 44310 represents an ileostomy or jejunostomy.
What if biopsy is performed during the ostomy creation?
When biopsy accompanies the colostomy or skin-level cecostomy, use 44322 rather than reporting the creation as 44320.
Is routine postoperative care separately reported?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
How is 44320 handled with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is not appropriate for this code.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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.
5,38144312,,Revision of ileostomy,A,,9.19,5.83,NA,5.83,,1.99,17.01,17.01,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38244314,,Revision of ileostomy,A,,16.32,8.33,NA,8.33,,3.36,28.01,28.01,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38344316,,Devise bowel pouch,A,,23.00,10.49,NA,10.49,,6.16,39.65,39.65,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38444320,,Colostomy,A,,19.41,9.68,NA,9.68,,4.50,33.59,33.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38544322,,Colostomy with biopsies,A,,12.99,12.99,NA,12.99,,3.46,29.44,29.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38644340,,Revision of colostomy,A,,9.05,7.12,NA,7.12,,2.01,18.18,18.18,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38744345,,Revision of colostomy,A,,16.79,9.00,NA,9.00,,3.75,29.54,29.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00