CPT code 44213: Splenic flexure, laparoscopic add-on mobilization2026 Medicare rate & RVUs in California
Reports laparoscopic release of the splenic flexure to facilitate a partial colectomy, such as completing a colorectal resection or allowing a tension-free anastomosis.
CMS doesn’t publish an office rate for 44213 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 44213 covers
During laparoscopic colon surgery, the surgeon frees the splenic flexure from its attachments so the left colon can reach the planned resection or reconstruction site. This additional dissection may help provide adequate length for a colorectal anastomosis. It is performed by a general or colorectal surgeon in the operating room as part of a laparoscopic partial colectomy; it is not the colectomy itself.
Report 44213 only with an eligible primary procedure, such as a laparoscopic partial colectomy. The operative note should describe the flexure mobilization, rather than merely documenting routine exposure or the colon resection. CMS classifies this as an add-on code: it is billed with the primary procedure, and its payment is handled within that procedure's global period. The primary code identifies the colectomy and its reconstruction; 44213 identifies the separately documented flexure work.
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 44213 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $160.68 |
| Chico, CA | Unavailable | $158.75 |
| El Centro, CA | Unavailable | $158.87 |
| Fresno, CA | Unavailable | $158.75 |
| Hanford, CA | Unavailable | $158.75 |
| Los Angeles, CA | Unavailable | $166.89 |
| Madera, CA | Unavailable | $158.75 |
| Marin County, CA | Unavailable | $174.54 |
| Merced, CA | Unavailable | $158.75 |
| Modesto, CA | Unavailable | $158.75 |
| Napa, CA | Unavailable | $169.49 |
| Oxnard, CA | Unavailable | $164.42 |
| Redding, CA | Unavailable | $158.75 |
| Rest of California | Unavailable | $158.75 |
| Riverside, CA | Unavailable | $166.28 |
| Sacramento, CA | Unavailable | $162.77 |
| Salinas, CA | Unavailable | $162.09 |
| San Benito County, CA | Unavailable | $178.93 |
| San Diego, CA | Unavailable | $163.14 |
| San Francisco, CA | Unavailable | $173.74 |
| San Luis Obispo, CA | Unavailable | $159.94 |
| Santa Clara County, CA | Unavailable | $175.68 |
| Santa Cruz, CA | Unavailable | $162.50 |
| Santa Maria, CA | Unavailable | $161.94 |
| Santa Rosa, CA | Unavailable | $163.89 |
| Stockton, CA | Unavailable | $158.75 |
| Vallejo, CA | Unavailable | $168.34 |
| Visalia, CA | Unavailable | $158.75 |
| Yuba City, CA | Unavailable | $158.75 |
How the 44213 rate is calculated
Each of 44213’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 · 44213
RVUs × geographic indexes × conversion factor
Work3.41
3.41 RVUs× 1.000 GPCI
Practice expense0.83
0.83 RVUs× 1.000 GPCI
Malpractice0.70
0.70 RVUs× 1.000 GPCI
Adjusted RVUs
4.9400
Conversion factor
$33.4009
Medicare rate
$165.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44213
The CMS indicators that decide how 44213 is paid alongside other services.
CMS payment indicators · 44213
Splenic flexure, laparoscopic add-on mobilization
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
44213 without 80 · national facility
$165.00
Splenic flexure, laparoscopic add-on mobilization
44213-80 · Assistant: 16%
$26.40
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
44213 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44204Partial colectomyLaparoscopic with anastomosis
- 44204 reports the laparoscopic partial colectomy with anastomosis. Add 44213 only when the surgeon also performs and documents splenic flexure mobilization.
- 44207ColectomyLow pelvic anastomosis
- 44207 identifies a laparoscopic left colectomy with coloproctostomy. It is the primary resection and reconstruction code; 44213 reports additional flexure mobilization.
- 44208ColectomyLow pelvic anastomosis with colostomy
- 44208 describes a laparoscopic left colectomy with coloproctostomy and colostomy. It does not replace 44213 when separately documented flexure mobilization is performed.
44213 billing questions
Can 44213 be billed by itself?
No. It is an add-on and must be reported with a qualifying primary procedure, such as a laparoscopic partial colectomy.
Does every laparoscopic partial colectomy include 44213?
No. Report it when the surgeon performs and documents splenic flexure mobilization; a colectomy alone does not establish that this additional work occurred.
What documentation supports 44213?
The operative report should describe the laparoscopic dissection and release of the splenic flexure, in addition to the primary colectomy and reconstruction.
Which code describes the colectomy itself?
The primary colectomy code describes the resection and reconstruction, such as 44204 or 44207. Code 44213 identifies the additional flexure mobilization.
How does the global period affect 44213?
CMS treats 44213 as an add-on paid within the primary procedure's global period. Report it with the primary procedure rather than as an independent service.
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
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