Billing code 44345: Colostomy revisionMedicare rate & RVUs in Texas
Reports operative revision of an existing colostomy when the repair is complicated and requires bowel resection with anastomosis.
CMS doesn’t publish an office rate for 44345 in Texas.
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 44345 covers
A colorectal or general surgeon uses this code for a complicated revision of an existing colostomy that requires removing a segment of bowel and reconnecting the bowel. The operation addresses a stoma problem that cannot be managed with a simple revision; the operative report should make the extent of the repair clear. These procedures are generally performed in a surgical facility.
Select this service based on the work performed, not just the presence of a colostomy problem. Document the indication, the bowel resected, and the anastomosis; a simple revision or repair of a paracolostomy hernia points to a different code. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery 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.
Where 44345 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $990.94 |
| Beaumont | Unavailable | $950.71 |
| Brazoria | Unavailable | $960.89 |
| Dallas | Unavailable | $972.72 |
| Fort Worth | Unavailable | $971.34 |
| Galveston | Unavailable | $967.50 |
| Houston | Unavailable | $1,036.14 |
| Rest Of Texas | Unavailable | $959.18 |
How the 44345 rate is calculated
Each of 44345’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 · 44345
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.79Practice expense 9.00Malpractice 3.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44345
44345 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44345
Colostomy revision
| 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 · 44345
Colostomy revision
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
44345 without 51 · national facility
$986.66
Colostomy revision
44345-51 · Second procedure: 50%
$493.33
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%).
44345 compared with similar codes
Compare codes
44345 vs 44340 vs 44346 vs 44314: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44340Colostomy revision
- 44340 is for a simple colostomy revision. Choose 44345 when the documented revision requires bowel resection and anastomosis.
- 44346Colostomy revision
- 44346 includes repair of a paracolostomy hernia. 44345 is for complicated colostomy revision with bowel resection and anastomosis.
- 44314Ileostomy revision
- 44314 is for complicated revision of an ileostomy. 44345 applies to the corresponding complicated revision of a colostomy.
44345 billing questions
How is 44345 distinguished from 44340?
Use 44345 when the complicated revision includes bowel resection and anastomosis. A simple colostomy revision, such as one limited to the stoma, is represented by 44340.
When is 44346 a better fit?
44346 describes colostomy revision with repair of a paracolostomy hernia. Use 44345 when the documented operation instead involves complicated revision with bowel resection and anastomosis.
What operative details support 44345?
The report should identify the existing colostomy, the reason for revision, the bowel segment removed, and the anastomosis performed. Those details distinguish this operation from a simple revision.
How does the 90-day global affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Routine related follow-up during that period is part of the surgical package.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 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 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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