No office rate
44210 removes the colon without removing the rectum and may include ileostomy or ileoproctostomy. Choose 44211 when proctectomy and ileoanal pouch reconstruction are performed.
On this page
CMS RVU26D · Effective 2026-10-01
44211 Proctocolectomy Medicare reimbursement rates in Vermont
Reports laparoscopic removal of the colon and rectum with ileal pouch construction and connection to the anus, with a diverting loop ileostomy when performed. Compare 44211 office and facility rates across CMS payment localities in Vermont.
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 44211 in Vermont?
Vermont 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
$1836.13
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Colorectal surgery
About 44211: Laparoscopic restorative proctocolectomy with ileal pouch
Reports laparoscopic removal of the colon and rectum with ileal pouch construction and connection to the anus, with a diverting loop ileostomy when performed.
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.
CMS billing rules for 44211
- 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 RVU36.15 · 63%
- Practice expense (office) RVU16.36 · 28%
- Malpractice RVU5.19 · 9%
31
Medicare services in 2024 · #5647 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.
44211 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
44212 includes proctectomy with ileostomy but does not describe ileal pouch construction and ileoanal anastomosis. Those restorative steps distinguish 44211.
No office rate
44207 describes a laparoscopic partial colectomy with a low pelvic anastomosis. It is not the code for total proctocolectomy with an ileal pouch.
No office rate
44158 describes the open approach to total proctocolectomy with ileoanal pouch reconstruction; 44211 is for the laparoscopic approach.
Compare 44211 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
Vermont →
Office / nonfacility
Unavailable
Facility
$1836.13
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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 44211 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,374
- Code
- 44211
- Physician work
- 36.15
- Practice expense
- 16.36
- Malpractice
- 5.19
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 36.15 | × 1.000 | 36.1500 |
| Practice expense | 16.36 | × 0.990 | 16.1964 |
| Malpractice | 5.19 | × 0.506 | 2.6261 |
| Total RVUs | 54.9725 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1836.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 36.15 | 1 |
| Practice expense | 16.36 | 0.99 |
| Malpractice | 5.19 | 0.506 |
(36.15 × 1 + 16.36 × 0.99 + 5.19 × 0.506) × $33.4009 = $1836.13
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.
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 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.
5,37144207,,L colectomy/coloproctostomy,A,,31.12,11.90,NA,11.90,,6.36,49.38,49.38,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37244208,,L colectomy/coloproctostomy,A,,33.14,14.10,NA,14.10,,6.71,53.95,53.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37344210,,Laparo total proctocolectomy,A,,29.34,13.86,NA,13.86,,5.53,48.73,48.73,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37444211,,Lap colectomy w/proctectomy,A,,36.15,16.36,NA,16.36,,5.19,57.70,57.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37544212,,Laparo total proctocolectomy,A,,33.72,16.01,NA,16.01,,6.02,55.75,55.75,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37644213,,Lap mobil splenic fl add-on,A,,3.41,0.83,NA,0.83,,0.70,4.94,4.94,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,37744227,,Lap close enterostomy,A,,27.90,11.39,NA,11.39,,6.20,45.49,45.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817