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Billing code 44820: Mesenteric excisionMedicare rate & RVUs

Reports surgical removal of a lesion arising in the mesentery, such as a mesenteric cyst or tumor, rather than a lesion of the bowel itself.

CMS RVU26DEffective Oct 1, 2026109 payment localities59 Medicare services in 2024

Medicare pays $808.30 for 44820 nationally in a facility.

Medicare rate · 44820

Mesenteric excision

Swap in your local Medicare rate.

Work RVUs
13.39
Total RVUs
24.20
Global days
090

National rate · 2026

$808.30

Facility setting, before claim adjustments.

See every locality for 44820 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 44820 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 44820 covers

This service involves surgically removing a lesion located in the mesentery, the tissue that supports and carries vessels to the intestines. Typical targets include a mesenteric cyst or tumor. A general or colorectal surgeon may perform the operation during abdominal surgery in a hospital or other surgical facility. The operative report should identify the lesion’s mesenteric location and describe its removal, including any related bowel work.

Select this code when the removed lesion arises in the mesentery; a lesion of a bowel pouch or the bowel wall points to a different service. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be allowed; 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 44820 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

44820 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$726.22
Alaska*Unavailable$993.93
ArizonaUnavailable$783.60
ArkansasUnavailable$716.26
AtlantaUnavailable$837.54
AustinUnavailable$809.57
BakersfieldUnavailable$793.23
Baltimore/Surr. CntysUnavailable$861.43
BeaumontUnavailable$778.08
BrazoriaUnavailable$783.40

44820 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
44820 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 44820 rate is calculated

Each of 44820’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 · 44820

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.39Practice expense 7.23Malpractice 3.58

24.2000 adjusted RVUs×$33.4009 conversion factor=$808.30

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 44820

44820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 44820

Mesenteric excision

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 · 44820

Mesenteric excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

44820 without 51 · national facility

$808.30

Mesenteric excision

44820-51 · Second procedure: 50%

$404.15

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

44820 compared with similar codes

Compare codes

44820 vs 44800 vs 44850 vs 44120: national Medicare rates

Swap in your local Medicare rate.

  • 44820
    Mesenteric excision · 13.39 wRVU
    —
  • 44800
    Diverticulum excision · 11.75 wRVU
    —
  • 44850
    Mesentery repair · 11.81 wRVU
    —
  • 44120
    Small-bowel resection · 20.3 wRVU
    —

How to choose

44800Diverticulum excision
This code concerns a lesion arising in the mesentery. Code 44800 concerns removal of a Meckel diverticulum, which is a pouch of the small bowel.
44850Mesentery repair
Code 44820 removes a mesenteric lesion; code 44850 concerns repair of the mesentery rather than lesion excision.
44120Small-bowel resection
Code 44120 reports removal of a segment of small intestine. Use 44820 for the mesenteric lesion itself, and document any bowel resection separately.

Codes related to 44820

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

Codes related to 44820
CodeHow it relatesNational office range
Used instead
44800Diverticulum excisionFor excision of a Meckel diverticulum, a bowel pouch, rather than a mesenteric lesion.No office rate
Often billed with
44120Small-bowel resectionMay be relevant when the same operation also includes resection of small bowel.No office rate
44850Mesentery repairMesenteric repair may be performed in the same operation when separately indicated and documented.No office rate

44820 billing questions

How is this distinguished from excision of a bowel pouch?

Use this code when the lesion arises in the mesentery. A Meckel diverticulum is a bowel pouch, so its excision is a different service.

Does this code include removal of bowel?

The target here is a mesenteric lesion. If the operation also removes a segment of bowel, the operative report should describe that work separately for coding review.

Should modifier 50 be appended for a lesion on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this anatomy.

What postoperative care is included?

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 allowed. 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 44820PPRRVU2026_Oct_nonQPP.csv, line 5,450 (RVU26D)

Open CMS sourceHow we calculate rates

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