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CMS RVU26D · Effective 2026-10-01

44180 Adhesion release Medicare reimbursement rates in Vermont

Reports laparoscopic freeing of intestinal adhesions, such as adhesions contributing to bowel obstruction, when the lysis is a distinct surgical service. Compare 44180 office and facility rates across CMS payment localities in Vermont.

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 44180 in Vermont?

Vermont 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

$799.48

1 of 1 localities have a supported rate.

Payment area: Vermont

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.

Find 44180 in your payment locality →

Digestive surgery

About 44180: Laparoscopic intestinal adhesion release

Reports laparoscopic freeing of intestinal adhesions, such as adhesions contributing to bowel obstruction, when the lysis is a distinct surgical service.

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.

CMS billing rules for 44180

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 RVU14.89 · 58%
  • Practice expense (office) RVU7.20 · 28%
  • Malpractice RVU3.79 · 15%

7.7K

Medicare services in 2024 · #1607 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.

44180 compared with similar codes

Office rates for Vermont, from the same CMS release.

44005

Bowel adhesiolysis

Open approach

No office rate

Both describe intestinal adhesiolysis, but 44005 is the open approach; 44180 is performed laparoscopically.

44140

Partial colectomy

With anastomosis

No office rate

44140 reports open removal of part of the colon. It does not describe laparoscopic release of adhesions without bowel removal.

44204

Partial colectomy

Laparoscopic with anastomosis

No office rate

44204 reports laparoscopic partial colectomy. Choose it when part of the colon is removed; 44180 describes laparoscopic adhesiolysis.

Compare 44180 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

Office and facility base rates · shared scale starting at $0

  • Vermont →

    Office / nonfacility

    Unavailable

    Facility

    $799.48

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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 44180 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

5,362

Code
44180
Physician work
14.89
Practice expense
7.20
Malpractice
3.79

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Facility calculation for 44180 in Vermont
ComponentRVULocality factorAdjusted
Physician work14.89× 1.00014.8900
Practice expense7.20× 0.9907.1280
Malpractice3.79× 0.5061.9177
Total RVUs23.9357
Conversion factor× 33.4009

Facility rate, Vermont$799.48

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work14.891
Practice expense7.20.99
Malpractice3.790.506

(14.89 × 1 + 7.2 × 0.99 + 3.79 × 0.506) × $33.4009 = $799.48

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.

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 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.

RVUs for 44180PPRRVU2026_Oct_nonQPP.csv, line 5,362 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet