Billing code 44180: Adhesion releaseMedicare rate & RVUs in Texas
Reports laparoscopic freeing of intestinal adhesions, such as adhesions contributing to bowel obstruction, when the lysis is a distinct surgical service.
CMS doesn’t publish an office rate for 44180 in Texas.
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 44180 covers
A surgeon uses laparoscopic instruments to free the small intestine or other bowel from adhesions that restrict movement or contribute to obstruction. General and colorectal surgeons commonly perform the procedure in a hospital operating room. The operative work is directed at separating adherent bowel and releasing tethering bands; it does not describe removal of intestine. Adhesions may follow prior abdominal surgery or inflammation.
Report the code for laparoscopic adhesiolysis when the operative note supports substantive, distinct work, including the involved bowel and extent of release. Routine lysis needed to reach or complete another abdominal operation is generally included in that operation. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate for this intestinal service. An assistant at surgery may be paid; 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.
Where 44180 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $864.93 |
| Beaumont | Unavailable | $833.78 |
| Brazoria | Unavailable | $838.38 |
| Dallas | Unavailable | $849.95 |
| Fort Worth | Unavailable | $849.19 |
| Galveston | Unavailable | $844.94 |
| Houston | Unavailable | $914.31 |
| Rest Of Texas | Unavailable | $839.87 |
How the 44180 rate is calculated
Each of 44180’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 · 44180
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.89Practice expense 7.20Malpractice 3.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44180
44180 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 44180
Adhesion release
| 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 · 44180
Adhesion release
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
44180 without 51 · national facility
$864.42
Adhesion release
44180-51 · Second procedure: 50%
$432.21
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%).
44180 compared with similar codes
Compare codes
44180 vs 44005 vs 44140 vs 44204: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44005Bowel adhesiolysis
- Both describe intestinal adhesiolysis, but 44005 is the open approach; 44180 is performed laparoscopically.
- 44140Partial colectomy
- 44140 reports open removal of part of the colon. It does not describe laparoscopic release of adhesions without bowel removal.
- 44204Partial colectomy
- 44204 reports laparoscopic partial colectomy. Choose it when part of the colon is removed; 44180 describes laparoscopic adhesiolysis.
44180 billing questions
When should 44180 be chosen over open enterolysis?
Use 44180 when the adhesiolysis is performed laparoscopically. Open intestinal adhesiolysis is reported with 44005.
Can 44180 be reported with a bowel resection?
Routine adhesiolysis needed to expose or complete the resection is generally included. A distinct, substantive adhesiolysis may be separately reportable when the operative documentation supports it and applicable edits permit separate reporting.
What should the operative note document?
Document the laparoscopic approach, the bowel involved, the location and extent of adhesions, and the work required to free the bowel. If another procedure was performed, describe why the adhesiolysis was distinct from the work needed for that procedure.
Is modifier 50 appropriate for 44180?
No. Modifier 50 is inappropriate because intestinal adhesiolysis is not a bilateral service.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction. The 90-day global period includes the day-before preoperative visit and related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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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