CPT code 44238: Unlisted intestinal laparoscopy, no specific listed procedure2026 Medicare rate & RVUs

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

What 44238 covers

Use this code for a laparoscopic operation on the intestine when no specific CPT code accurately describes the work performed. It is an unlisted option, not a substitute for codes describing defined small-bowel resections or partial colectomies. A surgeon typically reports it for an uncommon or modified intestinal procedure performed through laparoscopic access. The operative note should identify the bowel treated, the technique and extent of the work, and why a listed code does not fit.

Medicare assigns this code physician fee schedule status C: CMS publishes no national payment, and the Medicare Administrative Contractor prices each claim. The contractor sets the global period. For multiple procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%.

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 44238 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

44238 rates by state

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

How the 44238 rate is calculated

Each of 44238’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.

Payment rules and modifiers for 44238

The CMS indicators that decide how 44238 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

44238 compared with similar codes

How to choose

44202Small bowel resectionSingle resection with anastomosis

44202 describes a defined laparoscopic small-intestine resection with anastomosis. Use 44238 only when the documented operation is not accurately represented by that or another specific code.

44204Partial colectomyLaparoscopic with anastomosis

44204 is for a defined laparoscopic partial colectomy with anastomosis. An unlisted code is appropriate only when the colectomy performed does not fit a specific listed procedure.

44205ColectomyTerminal ileum with ileocolostomy

44205 identifies a laparoscopic partial colectomy that includes removal of terminal ileum. Choose it when that specific operation matches the record rather than reporting the work as unlisted.

44206Partial colectomyEnd colostomy, closed distal segment

44206 describes a laparoscopic partial colectomy with end colostomy. Use 44238 when the intestinal operation has no specific listed code, not when this defined procedure was performed.

Codes related to 44238

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

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

Open CMS sourceHow we calculate rates