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CPT code 44603: Small bowel suture, each additional repair2026 Medicare rate & RVUs

Reports repair of each additional small-intestinal perforation or injury during the same operation after the initial repair is coded.

CMS RVU26DEffective Oct 1, 2026109 payment localities816 Medicare services in 2024

Medicare pays $1,484.34 for 44603 nationally in a facility.

Medicare rate · 44603

Small bowel suture, each additional repair

Office or facility?

Work RVUs
27.46
Total RVUs
44.44
Global days
090

National rate · 2026

$1,484.34

Facility setting, before claim adjustments.

See every locality for 44603 →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 44603 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 44603 covers

This code represents an additional suture repair of the small intestine during an operation for a perforation, wound, injury, or rupture. It is used by surgeons, commonly general or trauma surgeons, when more than one small-intestinal site requires repair in the same operative session. Typical cases arise during emergency surgery for penetrating or blunt abdominal trauma or for a perforated intestinal lesion.

Report it with 44602 for the initial small-intestinal repair, and document the additional repaired site or sites and the operative work performed. The unit represents an additional repair, not each individual stitch or needle pass. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 44603 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

44603 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,344.71
AlaskaUnavailable$1,865.46
ArizonaUnavailable$1,441.62
ArkansasUnavailable$1,327.85
Atlanta, GAUnavailable$1,537.32
Austin, TXUnavailable$1,480.80
Bakersfield, CAUnavailable$1,447.88
Baltimore area, MDUnavailable$1,576.89
Beaumont, TXUnavailable$1,437.52
Brazoria, TXUnavailable$1,439.63

44603 rates by state

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

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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
44603 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 44603 rate is calculated

Each of 44603’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 · 44603

RVUs × geographic indexes × conversion factor

Office or facility?

Work27.46

27.46 RVUs× 1.000 GPCI

Practice expense10.32

10.32 RVUs× 1.000 GPCI

Malpractice6.66

6.66 RVUs× 1.000 GPCI

Adjusted RVUs

44.4400

Conversion factor

$33.4009

Medicare rate

$1,484.34

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

Payment rules and modifiers for 44603

44603 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44603

Small bowel suture, each additional repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 44603

Small bowel suture, each additional repair

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

44603 without 51 · national facility

$1,484.34

Small bowel suture, each additional repair

44603-51 · Second procedure: 50%

$742.17

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

44603 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44603

    Small bowel suture, each additional repair27.46 wRVU

    Not priced

  • 44602

    Small-bowel repair, single injury perforation24.1 wRVU

    Not priced

  • 44604

    Colon repair, single perforation17.71 wRVU

    Not priced

  • 44605

    Colon repair, multiple perforations21.53 wRVU

    Not priced

How to choose

44602Small-bowel repairSingle injury perforation
44602 covers the initial small-intestinal repair. Use 44603 only for an additional repair during the same operation.
44604Colon repairSingle perforation
44604 is for suture repair of the large intestine; 44603 concerns an additional small-intestinal repair.
44605Colon repairMultiple perforations
44605 concerns repair of a large-intestinal lesion. Select 44603 for an additional small-intestinal repair, not based solely on the presence of a lesion.

Codes related to 44603

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

Codes related to 44603
CodeHow it relatesNational office range
Primary code
44602Small-bowel repair, single injury perforationPrimary code for the initial small-intestinal repair.No office rate
Used instead
44604Colon repair, single perforationRepairs large intestine rather than small intestine.No office rate
44605Colon repair, multiple perforationsAddresses repair of a large-intestinal lesion, not an additional small-intestinal repair.No office rate
44615Intestinal stricturoplasty, each small-bowel strictureIntestinal narrowing is treated with stricturoplasty rather than an additional suture repair.No office rate

44603 billing questions

When should 44603 be reported instead of 44602?

Use 44602 for the initial small-intestinal repair. Report 44603 for each additional repair in the same operation.

Does 44603 count individual stitches?

No. The unit represents an additional repaired site, not each stitch used to close that site. Document the separate site and repair.

Can 44603 be reported by itself?

It is an add-on code and is reported with 44602 for the initial small-intestinal repair.

What operative documentation supports an additional unit?

The operative report should identify the additional small-intestinal injury or perforation and describe its repair separately from the initial repair.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery 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 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 44603PPRRVU2026_Oct_nonQPP.csv, line 5,427 (RVU26D)

Open CMS sourceHow we calculate rates

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