Billing code 44603: Small bowel sutureMedicare rate & RVUs in Delaware
Reports repair of each additional small-intestinal perforation or injury during the same operation after the initial repair is coded.
CMS doesn’t publish an office rate for 44603 in Delaware.
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 9 sections
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.
44603 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,462.32 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 44603
Small bowel suture
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.
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
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%).
44603 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44602Small-bowel repair
- 44602 covers the initial small-intestinal repair. Use 44603 only for an additional repair during the same operation.
- 44604Colon repair
- 44604 is for suture repair of the large intestine; 44603 concerns an additional small-intestinal repair.
- 44605Colon repair
- 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.
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
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