No office rate
Choose 44186 for laparoscopic jejunostomy with a feeding tube. Choose 44187 for a laparoscopic ileostomy or jejunostomy without a tube.
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CMS RVU26D · Effective 2026-10-01
44186 Jejunostomy Medicare reimbursement rates in Utah
Reports laparoscopic placement of a jejunostomy feeding tube when enteral nutrition must bypass the stomach or oral intake is inadequate. Compare 44186 office and facility rates across CMS payment localities in Utah.
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 44186 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$604.08
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
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.
Laparoscopic surgery
About 44186: Laparoscopic feeding jejunostomy placement
Reports laparoscopic placement of a jejunostomy feeding tube when enteral nutrition must bypass the stomach or oral intake is inadequate.
A surgeon uses laparoscopic access to create an opening into the jejunum and place a feeding tube for enteral nutrition. The procedure is used when a patient needs nutrition delivered to the small intestine, such as when gastric feeding is not suitable. It is generally performed in an operating room, commonly during a facility-based surgical admission.
Report this code when the operative record supports laparoscopic jejunostomy tube placement; distinguish it from a laparoscopic non-tube ileostomy or jejunostomy. Documentation should identify the approach, jejunal site, tube placement, and clinical reason for feeding access. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 44186
- 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 RVU10.12 · 54%
- Practice expense (office) RVU6.00 · 32%
- Malpractice RVU2.59 · 14%
1.9K
Medicare services in 2024 · #2510 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.
44186 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
44300 represents enterostomy tube placement by a different operative approach. 44186 specifically represents laparoscopic placement of a feeding jejunostomy.
$748.04
49440 is percutaneous gastrostomy tube placement, not laparoscopic access to the jejunum. The procedure performed and the feeding site distinguish the codes.
Compare 44186 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.
1 of 1 payment localities
Utah →
Office / nonfacility
Unavailable
Facility
$604.08
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 44186 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,363
- Code
- 44186
- Physician work
- 10.12
- Practice expense
- 6.00
- Malpractice
- 2.59
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.12 | × 1.000 | 10.1200 |
| Practice expense | 6.00 | × 0.940 | 5.6400 |
| Malpractice | 2.59 | × 0.898 | 2.3258 |
| Total RVUs | 18.0858 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$604.08
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.12 | 1 |
| Practice expense | 6 | 0.94 |
| Malpractice | 2.59 | 0.898 |
(10.12 × 1 + 6 × 0.94 + 2.59 × 0.898) × $33.4009 = $604.08
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
44186 billing questions
How does this differ from 44187?
44186 is for laparoscopic jejunostomy with feeding-tube placement. 44187 describes a laparoscopic ileostomy or jejunostomy without a tube.
Can the tube placement and jejunostomy opening be billed separately?
The laparoscopic feeding jejunostomy is the service represented by 44186. Do not separately report the access creation as another procedure when it is part of that same operative service.
What documentation supports 44186?
The operative report should establish the laparoscopic approach, the jejunal site, placement of a feeding tube, and the clinical need for jejunal feeding.
How is postoperative care handled?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.
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.
5,36044158,,Colectomy w/neo-rectum pouch,A,,35.78,17.25,NA,17.25,,9.58,62.61,62.61,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,36144160,,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
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985