No office rate
Both codes repair injury perforations in the small intestine. Choose 44602 for one perforation and 44603 for multiple perforations.
On this page
CMS RVU26D · Effective 2026-10-01
44602 Small-bowel repair Medicare reimbursement rates in Guam
Reports operative repair of an injured small intestine with one perforation, such as a traumatic or inadvertent bowel injury. Compare 44602 office and facility rates across CMS payment localities in Guam.
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.
What does Medicare pay for 44602 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1244.94
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Intestinal surgery
About 44602: Single-perforation small-bowel injury repair
Reports operative repair of an injured small intestine with one perforation, such as a traumatic or inadvertent bowel injury.
This service covers surgical closure of a single perforation in the small intestine caused by an injury. A general or colorectal surgeon typically performs the repair in an operating room, often during an urgent operation for abdominal trauma or while addressing an injury recognized during another procedure. The operative report should identify the small-bowel site, the injury, and that the repair involved one perforation.
Choose this code for one small-intestinal injury perforation; multiple perforations point to 44603, while a large-intestinal injury points to 44604 or 44605 according to perforation count. The major-surgery global period includes 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 others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.
CMS billing rules for 44602
- 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 RVU24.10 · 62%
- Practice expense (office) RVU8.53 · 22%
- Malpractice RVU6.00 · 16%
1.9K
Medicare services in 2024 · #2525 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.
44602 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
44604 is for one injury perforation in the large intestine; 44602 is for one in the small intestine.
No office rate
44605 is for multiple injury perforations in the large intestine. Confirm both the bowel segment and perforation count before selecting the code.
No office rate
44615 treats an intestinal stricture with stricturoplasty. It is not the injury-perforation repair reported with 44602.
Compare 44602 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1244.94
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 44602 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,426
- Code
- 44602
- Physician work
- 24.10
- Practice expense
- 8.53
- Malpractice
- 6.00
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.10 | × 1.000 | 24.1000 |
| Practice expense | 8.53 | × 1.137 | 9.6986 |
| Malpractice | 6.00 | × 0.579 | 3.4740 |
| Total RVUs | 37.2726 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1244.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.1 | 1 |
| Practice expense | 8.53 | 1.137 |
| Malpractice | 6 | 0.579 |
(24.1 × 1 + 8.53 × 1.137 + 6 × 0.579) × $33.4009 = $1244.94
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.
44602 billing questions
How does 44602 differ from 44603?
44602 is for one small-bowel injury perforation. Use 44603 when the small intestine has multiple injury perforations.
How do I distinguish this from 44604 or 44605?
Those codes describe injury repair in the large intestine. Select the small- or large-intestine code based on the documented injury site, then use the perforation count to choose the level.
What documentation supports reporting 44602?
The operative report should establish an injury involving the small intestine, identify the repaired site, and document a single perforation.
Can modifier 50 be used?
No. Modifier 50 is inappropriate for this repair; the CMS bilateral adjustment does not apply to the code.
How does payment work when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The code has a 90-day major-surgery global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team-surgery billing 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 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.
5,42344408,,Colonoscopy w/decompression,A,,4.04,1.62,NA,1.62,,0.44,6.10,6.10,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,42444500,,Intro gastrointestinal tube,A,,0.38,0.07,NA,0.07,,0.04,0.49,0.49,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,4254450F,,Self-care ed provided to 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
5,42644602,,Suture small intestine,A,,24.10,8.53,NA,8.53,,6.00,38.63,38.63,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,42744603,,Suture small intestine,A,,27.46,10.32,NA,10.32,,6.66,44.44,44.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,42844604,,Suture large intestine,A,,17.71,7.20,NA,7.20,,4.27,29.18,29.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,42944605,,Repair of bowel lesion,A,,21.53,9.18,NA,9.18,,5.75,36.46,36.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014