CPT code 44211: Proctocolectomy2026 Medicare rate & RVUs in Rhode Island
Reports laparoscopic removal of the colon and rectum with ileal pouch construction and connection to the anus, with a diverting loop ileostomy when performed.
CMS doesn’t publish an office rate for 44211 in Rhode Island.
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 44211 covers
This laparoscopic restorative proctocolectomy removes the colon and rectum, forms an ileal reservoir, and connects it to the anus. Colorectal surgeons commonly perform it in an operating room for ulcerative colitis or familial adenomatous polyposis when ileoanal reconstruction is planned. A diverting loop ileostomy may be created as part of the operation.
Report 44211 when the completed procedure includes total colectomy with proctectomy, ileal pouch construction, and ileoanal anastomosis; the loop ileostomy, when performed, is included. The operative report should document the resection extent, pouch construction, anastomosis, and diversion. Medicare includes the day-before preoperative visit and related postoperative care through 90 days after surgery. 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. Report the combined operation as one procedure, not as paired-side services. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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.
44211 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | Unavailable | $1,949.48 |
How the 44211 rate is calculated
Each of 44211’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 · 44211
RVUs × geographic indexes × conversion factor
Work36.15
36.15 RVUs× 1.000 GPCI
Practice expense16.36
16.36 RVUs× 1.000 GPCI
Malpractice5.19
5.19 RVUs× 1.000 GPCI
Adjusted RVUs
57.7000
Conversion factor
$33.4009
Medicare rate
$1,927.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44211
44211 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44211
Proctocolectomy
| 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 · 44211
Proctocolectomy
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
44211 without 51 · national facility
$1,927.23
Proctocolectomy
44211-51 · Second procedure: 50%
$963.62
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%).
44211 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 44210Total colectomy
- 44210 removes the colon without removing the rectum and may include ileostomy or ileoproctostomy. Choose 44211 when proctectomy and ileoanal pouch reconstruction are performed.
- 44212Proctocolectomy
- 44212 includes proctectomy with ileostomy but does not describe ileal pouch construction and ileoanal anastomosis. Those restorative steps distinguish 44211.
- 44207Colectomy
- 44207 describes a laparoscopic partial colectomy with a low pelvic anastomosis. It is not the code for total proctocolectomy with an ileal pouch.
- 44158Colectomy
- 44158 describes the open approach to total proctocolectomy with ileoanal pouch reconstruction; 44211 is for the laparoscopic approach.
44211 billing questions
When should 44211 be chosen over 44212?
Use 44211 when the operation includes an ileal reservoir connected to the anus. Use 44212 for total proctocolectomy with an ileostomy when an ileoanal pouch reconstruction is not performed.
Is a diverting loop ileostomy separately reported?
The loop ileostomy, when performed as part of this operation, is included in 44211.
Can splenic flexure mobilization be reported separately?
Code 44213 is an add-on for qualifying laparoscopic splenic flexure mobilization performed with the primary colorectal procedure. Document the work performed and report it with the primary code.
What documentation supports reporting 44211?
The operative report should establish laparoscopic removal of the colon and rectum, ileal pouch construction, and ileoanal anastomosis, and state whether a loop ileostomy was created.
How should bilateral modifiers and the global period be handled?
Report the combined operation as one procedure rather than as right- and left-sided services. The 90-day global includes the day-before preoperative visit and related postoperative care.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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 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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