Billing code 44005: Bowel adhesiolysisMedicare rate & RVUs in Florida
Open adhesiolysis frees bowel from adhesions causing tethering or obstruction when the surgeon performs the work as a distinct abdominal procedure.
CMS doesn’t publish an office rate for 44005 in Florida.
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 44005 covers
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.
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 44005 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,146.40 |
| Miami | Unavailable | $1,263.22 |
| Rest Of Florida | Unavailable | $1,084.90 |
How the 44005 rate is calculated
Each of 44005’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 · 44005
RVUs × geographic indexes × conversion factor
Work18.00
18.00 RVUs× 1.000 GPCI
Practice expense8.01
8.01 RVUs× 1.000 GPCI
Malpractice4.54
4.54 RVUs× 1.000 GPCI
Adjusted RVUs
30.5500
Conversion factor
$33.4009
Medicare rate
$1,020.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44005
44005 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44005
Bowel adhesiolysis
| 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 · 44005
Bowel adhesiolysis
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
44005 without 51 · national facility
$1,020.40
Bowel adhesiolysis
44005-51 · Second procedure: 50%
$510.20
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%).
44005 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44180Adhesion release
- Choose 44005 for open adhesiolysis and 44180 when the surgeon frees bowel adhesions laparoscopically.
- 44120Small-bowel resection
- 44005 frees bowel from adhesions; 44120 removes a segment of small intestine and reconnects the bowel.
- 44050Bowel obstruction reduction
- 44005 addresses bowel tethering from adhesions. 44050 is for open reduction of obstruction from a different mechanical cause.
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 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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