No office rate
44120 reports the primary small-intestine resection with anastomosis. Use 44121 only for an additional resection and anastomosis in the same operative session.
On this page
CMS RVU26D · Effective 2026-10-01
44121 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$205.78
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.
Small intestine surgery
About 44121: Additional small bowel resection with anastomosis
Reports an additional small-intestine segment resection with anastomosis performed during an operative session that includes the primary resection.
This add-on describes another small-intestine segment resection with an anastomosis during the same operative session as the primary resection. A surgeon may perform it when separate diseased segments require individual removal and reconnection, such as in a patient with more than one affected area of bowel. It distinguishes an additional resection and anastomosis from simply removing a longer continuous segment.
Report 44121 with the applicable primary procedure, not by itself. The operative report should establish that an additional segment was resected and anastomosed, beyond the resection represented by the primary code. CMS treats this as an add-on code: payment is handled within the primary procedure’s global period. The primary procedure and the additional work should be identifiable in the operative documentation.
CMS billing rules for 44121
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.33 · 67%
- Practice expense (office) RVU1.08 · 17%
- Malpractice RVU1.07 · 17%
1.7K
Medicare services in 2024 · #2566 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.
44121 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
44125 describes a small-intestine resection with enterostomy. 44121 is for additional resection work with anastomosis.
No office rate
44203 is the laparoscopic add-on for additional small-intestine resection and anastomosis; 44121 is the corresponding add-on for the open procedure.
The same code, a different location
How does Merced compare?
44121 across payment areas
Same release and payment basis · bars start at $0
Merced · 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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Madera
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Modesto
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Napa
California · 44121
Office
Unavailable
Facility
$219.44
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 44121
Office
Unavailable
Facility
$213.58
No comparable office rate is available.
Redding
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Rest Of California
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 44121
Office
Unavailable
Facility
$217.25
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 44121
Office
Unavailable
Facility
$210.94
No comparable office rate is available.
Salinas
California · 44121
Office
Unavailable
Facility
$210.07
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 44121
Office
Unavailable
Facility
$211.48
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 44121
Office
Unavailable
Facility
$225.63
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 44121
Office
Unavailable
Facility
$224.42
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 44121
Office
Unavailable
Facility
$231.71
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 44121
Office
Unavailable
Facility
$226.74
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 44121
Office
Unavailable
Facility
$207.33
No comparable office rate is available.
Santa Cruz-Watsonville
California · 44121
Office
Unavailable
Facility
$210.65
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 44121
Office
Unavailable
Facility
$209.89
No comparable office rate is available.
Santa Rosa-Petaluma
California · 44121
Office
Unavailable
Facility
$212.42
No comparable office rate is available.
Stockton
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Vallejo
California · 44121
Office
Unavailable
Facility
$217.69
No comparable office rate is available.
Visalia
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Yuba City
California · 44121
Office
Unavailable
Facility
$205.78
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 44121
Office
Unavailable
Facility
$234.71
No comparable office rate is available.
Miami
Florida · 44121
Office
Unavailable
Facility
$272.56
No comparable office rate is available.
Chicago
Illinois · 44121
Office
Unavailable
Facility
$263.91
No comparable office rate is available.
Manhattan
New York · 44121
Office
Unavailable
Facility
$252.48
No comparable office rate is available.
Alaska*
Alaska · 44121
Office
Unavailable
Facility
$275.05
No comparable office rate is available.
Alabama
Alabama · 44121
Office
Unavailable
Facility
$196.42
No comparable office rate is available.
Arkansas
Arkansas · 44121
Office
Unavailable
Facility
$194.02
No comparable office rate is available.
Arizona
Arizona · 44121
Office
Unavailable
Facility
$210.17
No comparable office rate is available.
Colorado
Colorado · 44121
Office
Unavailable
Facility
$212.66
No comparable office rate is available.
Connecticut
Connecticut · 44121
Office
Unavailable
Facility
$229.61
No comparable office rate is available.
Delaware
Delaware · 44121
Office
Unavailable
Facility
$213.12
No comparable office rate is available.
Fort Lauderdale
Florida · 44121
Office
Unavailable
Facility
$245.78
No comparable office rate is available.
Rest Of Florida
Florida · 44121
Office
Unavailable
Facility
$232.83
No comparable office rate is available.
Atlanta
Georgia · 44121
Office
Unavailable
Facility
$224.63
No comparable office rate is available.
Rest Of Georgia
Georgia · 44121
Office
Unavailable
Facility
$219.40
No comparable office rate is available.
Hawaii, Guam
Hawaii · 44121
Office
Unavailable
Facility
$206.33
No comparable office rate is available.
Iowa
Iowa · 44121
Office
Unavailable
Facility
$191.82
No comparable office rate is available.
Idaho
Idaho · 44121
Office
Unavailable
Facility
$194.72
No comparable office rate is available.
East St. Louis
Illinois · 44121
Office
Unavailable
Facility
$249.79
No comparable office rate is available.
Rest Of Illinois
Illinois · 44121
Office
Unavailable
Facility
$233.42
No comparable office rate is available.
Suburban Chicago
Illinois · 44121
Office
Unavailable
Facility
$246.01
No comparable office rate is available.
Indiana
Indiana · 44121
Office
Unavailable
Facility
$195.43
No comparable office rate is available.
Kansas
Kansas · 44121
Office
Unavailable
Facility
$195.25
No comparable office rate is available.
Kentucky
Kentucky · 44121
Office
Unavailable
Facility
$209.40
No comparable office rate is available.
New Orleans
Louisiana · 44121
Office
Unavailable
Facility
$219.17
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 44121
Office
Unavailable
Facility
$210.79
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 44121
Office
Unavailable
Facility
$225.43
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 44121
Office
Unavailable
Facility
$213.41
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 44121
Office
Unavailable
Facility
$229.86
No comparable office rate is available.
Rest Of Maryland
Maryland · 44121
Office
Unavailable
Facility
$215.39
No comparable office rate is available.
Rest Of Maine
Maine · 44121
Office
Unavailable
Facility
$200.04
No comparable office rate is available.
Southern Maine
Maine · 44121
Office
Unavailable
Facility
$202.93
No comparable office rate is available.
Detroit
Michigan · 44121
Office
Unavailable
Facility
$239.69
No comparable office rate is available.
Rest Of Michigan
Michigan · 44121
Office
Unavailable
Facility
$217.91
No comparable office rate is available.
Minnesota
Minnesota · 44121
Office
Unavailable
Facility
$192.32
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 44121
Office
Unavailable
Facility
$213.42
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 44121
Office
Unavailable
Facility
$214.78
No comparable office rate is available.
Rest Of Missouri
Missouri · 44121
Office
Unavailable
Facility
$210.53
No comparable office rate is available.
Mississippi
Mississippi · 44121
Office
Unavailable
Facility
$202.10
No comparable office rate is available.
Montana**
Montana · 44121
Office
Unavailable
Facility
$216.37
No comparable office rate is available.
North Carolina
North Carolina · 44121
Office
Unavailable
Facility
$201.12
No comparable office rate is available.
North Dakota**
North Dakota · 44121
Office
Unavailable
Facility
$195.21
No comparable office rate is available.
Nebraska
Nebraska · 44121
Office
Unavailable
Facility
$191.43
No comparable office rate is available.
New Hampshire
New Hampshire · 44121
Office
Unavailable
Facility
$213.45
No comparable office rate is available.
Northern Nj
New Jersey · 44121
Office
Unavailable
Facility
$233.75
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 44121
Office
Unavailable
Facility
$229.01
No comparable office rate is available.
New Mexico
New Mexico · 44121
Office
Unavailable
Facility
$220.63
No comparable office rate is available.
Nevada**
Nevada · 44121
Office
Unavailable
Facility
$210.51
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 44121
Office
Unavailable
Facility
$263.14
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 44121
Office
Unavailable
Facility
$233.88
No comparable office rate is available.
Queens
New York · 44121
Office
Unavailable
Facility
$248.06
No comparable office rate is available.
Rest Of New York
New York · 44121
Office
Unavailable
Facility
$204.02
No comparable office rate is available.
Ohio
Ohio · 44121
Office
Unavailable
Facility
$213.59
No comparable office rate is available.
Oklahoma
Oklahoma · 44121
Office
Unavailable
Facility
$204.61
No comparable office rate is available.
Portland
Oregon · 44121
Office
Unavailable
Facility
$213.61
No comparable office rate is available.
Rest Of Oregon
Oregon · 44121
Office
Unavailable
Facility
$205.68
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 44121
Office
Unavailable
Facility
$227.42
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 44121
Office
Unavailable
Facility
$211.51
No comparable office rate is available.
Puerto Rico
Puerto Rico · 44121
Office
Unavailable
Facility
$216.30
No comparable office rate is available.
Rhode Island
Rhode Island · 44121
Office
Unavailable
Facility
$216.52
No comparable office rate is available.
South Carolina
South Carolina · 44121
Office
Unavailable
Facility
$208.34
No comparable office rate is available.
South Dakota**
South Dakota · 44121
Office
Unavailable
Facility
$192.71
No comparable office rate is available.
Tennessee
Tennessee · 44121
Office
Unavailable
Facility
$196.61
No comparable office rate is available.
Austin
Texas · 44121
Office
Unavailable
Facility
$214.75
No comparable office rate is available.
Beaumont
Texas · 44121
Office
Unavailable
Facility
$210.65
No comparable office rate is available.
Brazoria
Texas · 44121
Office
Unavailable
Facility
$209.41
No comparable office rate is available.
Dallas
Texas · 44121
Office
Unavailable
Facility
$212.52
No comparable office rate is available.
Fort Worth
Texas · 44121
Office
Unavailable
Facility
$212.62
No comparable office rate is available.
Galveston
Texas · 44121
Office
Unavailable
Facility
$211.20
No comparable office rate is available.
Houston
Texas · 44121
Office
Unavailable
Facility
$230.78
No comparable office rate is available.
Rest Of Texas
Texas · 44121
Office
Unavailable
Facility
$211.13
No comparable office rate is available.
Utah
Utah · 44121
Office
Unavailable
Facility
$210.63
No comparable office rate is available.
Virginia
Virginia · 44121
Office
Unavailable
Facility
$205.32
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 44121
Office
Unavailable
Facility
$216.30
No comparable office rate is available.
Vermont
Vermont · 44121
Office
Unavailable
Facility
$198.42
No comparable office rate is available.
Rest Of Washington
Washington · 44121
Office
Unavailable
Facility
$211.69
No comparable office rate is available.
Seattle (King Cnty)
Washington · 44121
Office
Unavailable
Facility
$225.32
No comparable office rate is available.
Wisconsin
Wisconsin · 44121
Office
Unavailable
Facility
$190.19
No comparable office rate is available.
West Virginia
West Virginia · 44121
Office
Unavailable
Facility
$227.12
No comparable office rate is available.
Wyoming**
Wyoming · 44121
Office
Unavailable
Facility
$207.15
No comparable office rate is available.
See how rates vary across the country
44121 · 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?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, 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 44121 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$226.36
$205.78 × 110% = $226.36
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 44121 in Merced.
PPRRVU2026_Oct_nonQPP.csv
5,336
- Code
- 44121
- Physician work
- 4.33
- Practice expense
- 1.08
- Malpractice
- 1.07
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.33 | × 1.017 | 4.4036 |
| Practice expense | 1.08 | × 1.096 | 1.1837 |
| Malpractice | 1.07 | × 0.536 | 0.5735 |
| Total RVUs | 6.1608 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$205.78
Open 44121 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.33 | 1.017 |
| Practice expense | 1.08 | 1.096 |
| Malpractice | 1.07 | 0.536 |
(4.33 × 1.017 + 1.08 × 1.096 + 1.07 × 0.536) × $33.4009 = $205.78
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
44121 · 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 | $205.78 | RVU26D |
| 2026-07-01 | Not available in this setting | $205.78 | RVU26C |
| 2026-04-01 | Not available in this setting | $205.78 | RVU26B |
| 2026-01-01 | Not available in this setting | $205.78 | RVU26A |
| 2025-10-01 | Not available in this setting | $224.22 | RVU25D |
| 2025-07-01 | Not available in this setting | $224.22 | RVU25C |
| 2025-04-01 | Not available in this setting | $224.22 | RVU25B |
| 2025-01-01 | Not available in this setting | $224.22 | RVU25A |
44121 billing questions
When is 44121 reported with 44120?
Use 44121 for an additional small-intestine resection and anastomosis beyond the primary resection reported with 44120. The additional work must be documented in the operative report.
Can 44121 be billed by itself?
No. It is an add-on code and must be reported with an applicable primary procedure.
Does a longer single resection support 44121?
Not by itself. The documentation should show another resection and anastomosis, rather than only a longer continuous segment removed as part of the primary resection.
How does 44121 differ from 44125?
44121 represents an additional resection with anastomosis. 44125 describes a small-intestine resection with an enterostomy, a different reconstruction.
How is 44121 paid in relation to the primary procedure?
CMS identifies it as an add-on code paid within the primary procedure’s global period. It cannot be reported without the primary procedure.
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.
5,33344110,,Excise intestine lesion(s),A,,13.69,7.00,NA,7.00,,3.18,23.87,23.87,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33444111,,Excision of bowel lesion(s),A,,16.11,7.57,NA,7.57,,3.43,27.11,27.11,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33544120,,Removal of small intestine,A,,20.30,8.62,NA,8.62,,5.10,34.02,34.02,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33644121,,Removal of small intestine,A,,4.33,1.08,NA,1.08,,1.07,6.48,6.48,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33744125,,Removal of small intestine,A,,19.53,8.63,NA,8.63,,4.70,32.86,32.86,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33844126,,Enterectomy w/o taper cong,A,,41.17,16.20,NA,16.20,,11.05,68.42,68.42,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33944127,,Enterectomy w/taper cong,A,,48.07,17.73,NA,17.73,,12.87,78.67,78.67,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623