CPT code 44238: Unlisted intestinal laparoscopy, no specific listed procedure2026 Medicare rate & RVUs in Massachusetts
Reports a laparoscopic intestinal operation when no specific CPT code describes the procedure performed on the small or large bowel.
CMS doesn’t publish an office rate for 44238 in Massachusetts.
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 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 in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | Unavailable |
| Rest of Massachusetts | Unavailable | Unavailable |
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.
How the rate is built · 44238
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44238
The CMS indicators that decide how 44238 is paid alongside other services.
CMS payment indicators · 44238
Unlisted intestinal laparoscopy, no specific listed procedure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
44238 without 50 · national facility
$0.00
Unlisted intestinal laparoscopy, no specific listed procedure
44238-50 · Bilateral: 150%
$0.00
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
44238 compared with similar codes
Compare codes · National
5 codes, side by side
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.
44238 billing questions
When should 44238 be used instead of a listed laparoscopic bowel code?
Use 44238 when no specific listed CPT code accurately describes the intestinal procedure performed. For a defined small-bowel resection or partial colectomy, select the code for that operation.
What documentation supports a claim for 44238?
Describe the bowel treated, laparoscopic technique, extent of the operation, and why a specific listed code does not represent the work.
How does Medicare price 44238?
Its physician fee schedule status is C, so CMS publishes no national payment and the Medicare Administrative Contractor prices each claim.
How does Medicare treat multiple procedures in the same session?
The highest-valued procedure is paid in full and the other procedures at 50%.
How does Medicare treat a bilateral procedure reported with modifier 50?
Medicare pays a bilateral procedure reported with modifier 50 at 150%.
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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