No office rate
Choose 44186 for laparoscopic jejunostomy with a tube, commonly for feeding or decompression. Choose 44187 for a non-tube ileostomy or jejunostomy.
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CMS RVU26D · Effective 2026-10-01
44187 Laparoscopic ostomy Medicare reimbursement rates in Texas
Reports laparoscopic creation of a non-tube ileostomy or jejunostomy, typically to divert intestinal contents through a surgically created abdominal opening. Compare 44187 office and facility rates across CMS payment localities in Texas.
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 44187 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 44187 pays more and less in Texas
Digestive surgery
About 44187: Laparoscopic non-tube ileostomy or jejunostomy
Reports laparoscopic creation of a non-tube ileostomy or jejunostomy, typically to divert intestinal contents through a surgically created abdominal opening.
The surgeon uses a laparoscopic approach to bring a segment of ileum or jejunum to the abdominal wall and create a non-tube stoma. This may provide intestinal diversion when the downstream bowel needs to be bypassed, such as to protect a distal anastomosis or manage obstruction. The code describes an ostomy, not placement of a feeding or decompression tube. It is generally performed by a general or colorectal surgeon in a hospital operating room.
Report the code when the operative documentation supports laparoscopic creation of a non-tube ileostomy or jejunostomy; document the bowel segment, approach, and stoma created. 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 44187
- 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 RVU16.97 · 55%
- Practice expense (office) RVU10.31 · 34%
- Malpractice RVU3.40 · 11%
1.6K
Medicare services in 2024 · #2635 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.
44187 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
44188 creates a laparoscopic colostomy or skin-level cecostomy; 44187 creates an ileal or jejunal stoma.
No office rate
44310 describes open creation of a non-tube ileostomy or jejunostomy. Use 44187 when the documented approach is laparoscopic.
Compare 44187 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $1032.90 |
| Beaumont | Office Unavailable | Facility $985.68 |
| Brazoria | Office Unavailable | Facility $1001.19 |
| Dallas | Office Unavailable | Facility $1012.34 |
| Fort Worth | Office Unavailable | Facility $1010.37 |
| Galveston | Office Unavailable | Facility $1007.33 |
| Houston | Office Unavailable | Facility $1069.56 |
| Rest Of Texas | Office Unavailable | Facility $996.16 |
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44187 billing questions
How is this different from 44186?
44187 is for a non-tube ileostomy or jejunostomy. 44186 describes laparoscopic jejunostomy with a tube, such as for feeding or decompression.
When should 44188 be reported instead?
Use 44188 when the laparoscopically created ostomy is a colostomy or skin-level cecostomy. Code 44187 is for an ileal or jejunal stoma.
Can 44187 be used for an open procedure?
No. This code describes laparoscopic ostomy creation; 44310 is the open non-tube ileostomy or jejunostomy alternative.
Is modifier 50 appropriate for two ostomies?
CMS identifies bilateral adjustment as inappropriate for this code. Modifier 50 should not be used to represent bilateral performance.
What documentation supports reporting 44187?
The operative report should establish the laparoscopic approach, whether ileum or jejunum was used, and creation of a non-tube stoma. It should distinguish the service from tube jejunostomy.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
5,36144160,,Removal of colon,A,,20.37,9.38,NA,9.38,,4.90,34.65,34.65,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36244180,,Lap enterolysis,A,,14.89,7.20,NA,7.20,,3.79,25.88,25.88,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36344186,,Lap jejunostomy,A,,10.12,6.00,NA,6.00,,2.59,18.71,18.71,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36444187,,Lap ileo/jejuno-stomy,A,,16.97,10.31,NA,10.31,,3.40,30.68,30.68,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36544188,,Lap colostomy,A,,18.87,11.04,NA,11.04,,4.21,34.12,34.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36644202,,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