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CPT code 44203: Small bowel resection, each additional resection2026 Medicare rate & RVUs

Report 44203 for each additional laparoscopic small-intestine resection with anastomosis beyond the primary resection, together with 44202.

CMS RVU26DEffective Oct 1, 2026109 payment localities159 Medicare services in 2024

Medicare pays $216.10 for 44203 nationally in a facility.

Medicare rate · 44203

Small bowel resection, each additional resection

Office or facility?

Work RVUs
4.33
Total RVUs
6.47
Global days
ZZZ

National rate · 2026

$216.10

Facility setting, before claim adjustments.

See every locality for 44203 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 44203 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 44203 covers

Code 44203 captures an additional laparoscopic resection and reconnection of small intestine during the same operative session as the primary small-bowel resection. Multiple separate diseased segments, such as skip areas of Crohn disease or separate ischemic segments, may require additional resections and anastomoses. General and colorectal surgeons typically perform this work in an operating room using laparoscopic access.

Report 44203 only with the primary procedure, 44202. Count additional resection-and-anastomosis work, not the length of bowel removed or the number of pathology specimens. The operative report should identify the laparoscopic approach and describe each additional small-bowel segment resected and reconstructed. CMS classifies 44203 as an add-on code: it is billed only with a primary procedure, and payment is within that procedure’s global period.

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 44203 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

44203 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$196.13
AlaskaUnavailable$274.69
ArizonaUnavailable$209.85
ArkansasUnavailable$193.73
Atlanta, GAUnavailable$224.29
Austin, TXUnavailable$214.39
Bakersfield, CAUnavailable$208.31
Baltimore area, MDUnavailable$229.50
Beaumont, TXUnavailable$210.35
Brazoria, TXUnavailable$209.08

44203 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
44203 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 44203 rate is calculated

Each of 44203’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 · 44203

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.33

4.33 RVUs× 1.000 GPCI

Practice expense1.07

1.07 RVUs× 1.000 GPCI

Malpractice1.07

1.07 RVUs× 1.000 GPCI

Adjusted RVUs

6.4700

Conversion factor

$33.4009

Medicare rate

$216.10

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 44203

The CMS indicators that decide how 44203 is paid alongside other services.

CMS payment indicators · 44203

Small bowel resection, each additional resection

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

44203 without 80 · national facility

$216.10

Small bowel resection, each additional resection

44203-80 · Assistant: 16%

$34.58

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

44203 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44203

    Small bowel resection, each additional resection4.33 wRVU

    Not priced

  • 44202

    Small bowel resection, single resection with anastomosis22.81 wRVU

    Not priced

  • 44121

    Small bowel resection, each additional resection4.33 wRVU

    Not priced

  • 44204

    Partial colectomy, laparoscopic with anastomosis25.76 wRVU

    Not priced

How to choose

44202Small bowel resectionSingle resection with anastomosis
44202 reports the primary laparoscopic small-bowel resection and anastomosis. Use 44203 only for additional resection-and-anastomosis work in the same operative session.
44121Small bowel resectionEach additional resection
44121 describes additional small-intestine resection and anastomosis using an open approach. Code 44203 is for additional work performed laparoscopically.
44204Partial colectomyLaparoscopic with anastomosis
44204 concerns laparoscopic partial colectomy involving the large intestine. Code 44203 applies to additional small-intestine resection and anastomosis.

Codes related to 44203

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 44203
CodeHow it relatesNational office range
Add-on codes
44202Small bowel resection, single resection with anastomosisPrimary laparoscopic small-bowel resection and anastomosis reported with this add-on.No office rate
Used instead
44121Small bowel resection, each additional resectionOpen-surgery counterpart for an additional small-intestine resection and anastomosis.No office rate
44120Small-bowel resection, single resection with anastomosisOpen approach to a primary small-intestine resection and anastomosis.No office rate
44238Unlisted intestinal laparoscopy, no specific listed procedureUnlisted laparoscopic intestinal procedure when no specific listed code describes the service.No office rate

44203 billing questions

When is 44203 reported instead of 44202?

44202 represents the primary laparoscopic small-bowel resection with anastomosis. Report 44203 for each additional resection and anastomosis performed in that operative session.

Can 44203 be billed by itself?

No. It is an add-on code and must be reported with the primary procedure, 44202.

Are units based on bowel length or specimen count?

No. The code describes additional resection-and-anastomosis work. The operative report should support each additional resection and reconstruction.

What documentation supports an additional unit?

Document the laparoscopic approach, the additional small-bowel segment removed, and the anastomosis performed for that segment.

How does the global-period payment rule affect 44203?

CMS pays this add-on within the primary procedure’s global period. It is not billed apart from the qualifying primary procedure.

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
RVUs for 44203PPRRVU2026_Oct_nonQPP.csv, line 5,367 (RVU26D)

Open CMS sourceHow we calculate rates

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