No office rate
Choose 44005 for open adhesiolysis and 44180 when the surgeon frees bowel adhesions laparoscopically.
On this page
CMS RVU26D · Effective 2026-10-01
44005 in Houston
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1080.35
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Digestive surgery
About 44005: Open freeing of bowel adhesions
Open adhesiolysis frees bowel from adhesions causing tethering or obstruction when the surgeon performs the work as a distinct abdominal procedure.
The surgeon reaches the abdominal cavity through an incision and carefully divides adhesions that tether or obstruct the bowel. General surgeons commonly perform this in a hospital operating room when adhesions are the focus of treatment, such as in a patient with adhesive small-bowel obstruction. This code represents open surgery; laparoscopic freeing of bowel adhesions is reported with a different code.
Report 44005 when the adhesiolysis is a distinct procedure, rather than routine release of adhesions needed to expose or complete another abdominal operation. The operative note should describe the adhesions, the bowel involved, and the work performed to free it. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this unpaired bowel procedure. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 44005
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.00 · 59%
- Practice expense (office) RVU8.01 · 26%
- Malpractice RVU4.54 · 15%
7.1K
Medicare services in 2024 · #1653 by national volume
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.
44005 compared with similar codes
Office rates for Houston, from the same CMS release.
No office rate
44005 frees bowel from adhesions; 44120 removes a segment of small intestine and reconnects the bowel.
No office rate
44005 addresses bowel tethering from adhesions. 44050 is for open reduction of obstruction from a different mechanical cause.
The same code, a different location
How does Houston compare?
44005 across payment areas
Same release and payment basis · bars start at $0
Houston · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 44005
Office
Unavailable
Facility
$992.04
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 44005
Office
Unavailable
Facility
$1043.06
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 44005
Office
Unavailable
Facility
$1117.62
No comparable office rate is available.
Miami
Florida · 44005
Office
Unavailable
Facility
$1263.22
No comparable office rate is available.
Chicago
Illinois · 44005
Office
Unavailable
Facility
$1222.32
No comparable office rate is available.
Manhattan
New York · 44005
Office
Unavailable
Facility
$1191.08
No comparable office rate is available.
Alaska*
Alaska · 44005
Office
Unavailable
Facility
$1270.31
No comparable office rate is available.
Alabama
Alabama · 44005
Office
Unavailable
Facility
$921.14
No comparable office rate is available.
Arkansas
Arkansas · 44005
Office
Unavailable
Facility
$909.13
No comparable office rate is available.
Arizona
Arizona · 44005
Office
Unavailable
Facility
$990.27
No comparable office rate is available.
Bakersfield
California · 44005
Office
Unavailable
Facility
$998.21
No comparable office rate is available.
Chico
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
El Centro
California · 44005
Office
Unavailable
Facility
$986.70
No comparable office rate is available.
Fresno
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Hanford-Corcoran
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Madera
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Merced
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Modesto
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Napa
California · 44005
Office
Unavailable
Facility
$1068.75
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 44005
Office
Unavailable
Facility
$1028.76
No comparable office rate is available.
Redding
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Rest Of California
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 44005
Office
Unavailable
Facility
$1034.61
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 44005
Office
Unavailable
Facility
$1015.29
No comparable office rate is available.
Salinas
California · 44005
Office
Unavailable
Facility
$1011.21
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 44005
Office
Unavailable
Facility
$1021.42
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 44005
Office
Unavailable
Facility
$1105.17
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 44005
Office
Unavailable
Facility
$1100.01
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 44005
Office
Unavailable
Facility
$1134.42
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 44005
Office
Unavailable
Facility
$1113.35
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 44005
Office
Unavailable
Facility
$997.45
No comparable office rate is available.
Santa Cruz-Watsonville
California · 44005
Office
Unavailable
Facility
$1020.18
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 44005
Office
Unavailable
Facility
$1011.28
No comparable office rate is available.
Santa Rosa-Petaluma
California · 44005
Office
Unavailable
Facility
$1029.07
No comparable office rate is available.
Stockton
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Vallejo
California · 44005
Office
Unavailable
Facility
$1061.31
No comparable office rate is available.
Visalia
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Yuba City
California · 44005
Office
Unavailable
Facility
$985.94
No comparable office rate is available.
Colorado
Colorado · 44005
Office
Unavailable
Facility
$1011.53
No comparable office rate is available.
Connecticut
Connecticut · 44005
Office
Unavailable
Facility
$1084.87
No comparable office rate is available.
Delaware
Delaware · 44005
Office
Unavailable
Facility
$1004.88
No comparable office rate is available.
Fort Lauderdale
Florida · 44005
Office
Unavailable
Facility
$1146.40
No comparable office rate is available.
Rest Of Florida
Florida · 44005
Office
Unavailable
Facility
$1084.90
No comparable office rate is available.
Atlanta
Georgia · 44005
Office
Unavailable
Facility
$1056.96
No comparable office rate is available.
Rest Of Georgia
Georgia · 44005
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Hawaii, Guam
Hawaii · 44005
Office
Unavailable
Facility
$993.21
No comparable office rate is available.
Iowa
Iowa · 44005
Office
Unavailable
Facility
$906.22
No comparable office rate is available.
Idaho
Idaho · 44005
Office
Unavailable
Facility
$919.08
No comparable office rate is available.
East St. Louis
Illinois · 44005
Office
Unavailable
Facility
$1152.76
No comparable office rate is available.
Rest Of Illinois
Illinois · 44005
Office
Unavailable
Facility
$1082.49
No comparable office rate is available.
Suburban Chicago
Illinois · 44005
Office
Unavailable
Facility
$1148.90
No comparable office rate is available.
Indiana
Indiana · 44005
Office
Unavailable
Facility
$922.92
No comparable office rate is available.
Kansas
Kansas · 44005
Office
Unavailable
Facility
$919.50
No comparable office rate is available.
Kentucky
Kentucky · 44005
Office
Unavailable
Facility
$977.81
No comparable office rate is available.
New Orleans
Louisiana · 44005
Office
Unavailable
Facility
$1025.24
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 44005
Office
Unavailable
Facility
$983.26
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 44005
Office
Unavailable
Facility
$1080.27
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 44005
Office
Unavailable
Facility
$1013.41
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 44005
Office
Unavailable
Facility
$1085.49
No comparable office rate is available.
Rest Of Maryland
Maryland · 44005
Office
Unavailable
Facility
$1017.19
No comparable office rate is available.
Rest Of Maine
Maine · 44005
Office
Unavailable
Facility
$941.67
No comparable office rate is available.
Southern Maine
Maine · 44005
Office
Unavailable
Facility
$962.03
No comparable office rate is available.
Detroit
Michigan · 44005
Office
Unavailable
Facility
$1115.06
No comparable office rate is available.
Rest Of Michigan
Michigan · 44005
Office
Unavailable
Facility
$1016.68
No comparable office rate is available.
Minnesota
Minnesota · 44005
Office
Unavailable
Facility
$921.40
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 44005
Office
Unavailable
Facility
$1000.59
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 44005
Office
Unavailable
Facility
$1007.86
No comparable office rate is available.
Rest Of Missouri
Missouri · 44005
Office
Unavailable
Facility
$979.53
No comparable office rate is available.
Mississippi
Mississippi · 44005
Office
Unavailable
Facility
$943.63
No comparable office rate is available.
Montana**
Montana · 44005
Office
Unavailable
Facility
$1020.09
No comparable office rate is available.
North Carolina
North Carolina · 44005
Office
Unavailable
Facility
$947.73
No comparable office rate is available.
North Dakota**
North Dakota · 44005
Office
Unavailable
Facility
$930.32
No comparable office rate is available.
Nebraska
Nebraska · 44005
Office
Unavailable
Facility
$905.48
No comparable office rate is available.
New Hampshire
New Hampshire · 44005
Office
Unavailable
Facility
$1012.41
No comparable office rate is available.
Northern Nj
New Jersey · 44005
Office
Unavailable
Facility
$1111.39
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 44005
Office
Unavailable
Facility
$1083.77
No comparable office rate is available.
New Mexico
New Mexico · 44005
Office
Unavailable
Facility
$1028.67
No comparable office rate is available.
Nevada**
Nevada · 44005
Office
Unavailable
Facility
$995.34
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 44005
Office
Unavailable
Facility
$1239.40
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 44005
Office
Unavailable
Facility
$1104.71
No comparable office rate is available.
Queens
New York · 44005
Office
Unavailable
Facility
$1174.59
No comparable office rate is available.
Rest Of New York
New York · 44005
Office
Unavailable
Facility
$961.98
No comparable office rate is available.
Ohio
Ohio · 44005
Office
Unavailable
Facility
$998.33
No comparable office rate is available.
Oklahoma
Oklahoma · 44005
Office
Unavailable
Facility
$957.95
No comparable office rate is available.
Portland
Oregon · 44005
Office
Unavailable
Facility
$1020.89
No comparable office rate is available.
Rest Of Oregon
Oregon · 44005
Office
Unavailable
Facility
$974.29
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 44005
Office
Unavailable
Facility
$1071.46
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 44005
Office
Unavailable
Facility
$990.12
No comparable office rate is available.
Puerto Rico
Puerto Rico · 44005
Office
Unavailable
Facility
$1021.07
No comparable office rate is available.
Rhode Island
Rhode Island · 44005
Office
Unavailable
Facility
$1024.27
No comparable office rate is available.
South Carolina
South Carolina · 44005
Office
Unavailable
Facility
$977.32
No comparable office rate is available.
South Dakota**
South Dakota · 44005
Office
Unavailable
Facility
$919.71
No comparable office rate is available.
Tennessee
Tennessee · 44005
Office
Unavailable
Facility
$925.84
No comparable office rate is available.
Utah
Utah · 44005
Office
Unavailable
Facility
$988.88
No comparable office rate is available.
Virginia
Virginia · 44005
Office
Unavailable
Facility
$971.27
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 44005
Office
Unavailable
Facility
$1021.07
No comparable office rate is available.
Vermont
Vermont · 44005
Office
Unavailable
Facility
$942.81
No comparable office rate is available.
Rest Of Washington
Washington · 44005
Office
Unavailable
Facility
$1006.15
No comparable office rate is available.
Seattle (King Cnty)
Washington · 44005
Office
Unavailable
Facility
$1083.44
No comparable office rate is available.
Wisconsin
Wisconsin · 44005
Office
Unavailable
Facility
$904.23
No comparable office rate is available.
West Virginia
West Virginia · 44005
Office
Unavailable
Facility
$1050.71
No comparable office rate is available.
Wyoming**
Wyoming · 44005
Office
Unavailable
Facility
$980.97
No comparable office rate is available.
See how rates vary across the country
44005 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Houston is a Medicare payment area. Our Census mapping connects it to 46 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 44005 in Houston. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1188.38
$1080.35 × 110% = $1188.38
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 44005 in Houston.
PPRRVU2026_Oct_nonQPP.csv
5,323
- Code
- 44005
- Physician work
- 18.00
- Practice expense
- 8.01
- Malpractice
- 4.54
GPCI2026.csv
102
- Locality
- Houston
- Physician work
- 1.008
- Practice expense
- 0.993
- Malpractice
- 1.376
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.00 | × 1.008 | 18.1440 |
| Practice expense | 8.01 | × 0.993 | 7.9539 |
| Malpractice | 4.54 | × 1.376 | 6.2470 |
| Total RVUs | 32.3450 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Houston$1080.35
Open 44005 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18 | 1.008 |
| Practice expense | 8.01 | 0.993 |
| Malpractice | 4.54 | 1.376 |
(18 × 1.008 + 8.01 × 0.993 + 4.54 × 1.376) × $33.4009 = $1080.35
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
44005 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1080.35 | RVU26D |
| 2026-07-01 | Not available in this setting | $1080.35 | RVU26C |
| 2026-04-01 | Not available in this setting | $1080.35 | RVU26B |
| 2026-01-01 | Not available in this setting | $1080.35 | RVU26A |
| 2025-10-01 | Not available in this setting | $1131.68 | RVU25D |
| 2025-07-01 | Not available in this setting | $1131.68 | RVU25C |
| 2025-04-01 | Not available in this setting | $1131.68 | RVU25B |
| 2025-01-01 | Not available in this setting | $1131.68 | RVU25A |
44005 billing questions
How does 44005 differ from 44180?
44005 is the open approach to freeing bowel adhesions. 44180 describes laparoscopic enterolysis.
Can modifier 50 be used for adhesions on both sides of the abdomen?
No. The procedure is not a paired-side service, so modifier 50 is not appropriate.
Is postoperative care included in 44005?
Yes. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What happens when 44005 is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,32043888,,Gstr rstcv px opn rmvl&rplc,A,,6.28,5.86,NA,5.86,,1.67,13.81,13.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32143889,,Gstr rstcv px trnsorl esg,A,,12.56,7.00,NA,7.00,,1.99,21.55,21.55,0,090,0.09,0.84,0.07,3,0,0,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
5,32243999,,Unlisted procedure stomach,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32344005,,Freeing of bowel adhesion,A,,18.00,8.01,NA,8.01,,4.54,30.55,30.55,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,3244400F,,Rehab thxpy options w/pt,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32544010,,Incision of small bowel,A,,13.90,6.89,NA,6.89,,2.64,23.43,23.43,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32644015,,Insert needle cath bowel,A,,2.55,0.62,NA,0.62,,0.62,3.79,3.79,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9904412,TX,11,DALLAS,1.009,0.996,0.858
10004412,TX,28,FORT WORTH,1.009,0.986,0.871
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506