No office rate
Use 44021 when the small-bowel incision serves to decompress distended bowel. A small-bowel incision for another purpose belongs to the distinct incision service.
On this page
CMS RVU26D · Effective 2026-10-01
44021 Bowel decompression Medicare reimbursement rates in Virginia
Reports operative decompression of a distended small bowel, including when an enterotomy is used to release gas or intestinal contents. Compare 44021 office and facility rates across CMS payment localities in Virginia.
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 44021 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$865.78–$996.16
2 of 2 localities have a supported rate.
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.
Gastrointestinal surgery
About 44021: Small-bowel decompression
Reports operative decompression of a distended small bowel, including when an enterotomy is used to release gas or intestinal contents.
A surgeon reports this service when the small intestine is surgically decompressed during an abdominal operation, such as for marked bowel distention associated with ileus or obstruction. The procedure may include an enterotomy to release gas or intestinal contents; that incision is part of the decompression service. It is distinct from simply inspecting the bowel or freeing adhesions without decompressing it. This code is generally associated with facility-based surgery.
The operative report should identify the small bowel as the site and describe the distention, the decompression performed, and whether an enterotomy was used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 44021
- 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 RVU15.90 · 58%
- Practice expense (office) RVU7.35 · 27%
- Malpractice RVU3.96 · 15%
283
Medicare services in 2024 · #4037 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.
44021 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Exploration concerns inspection of the small intestine, with or without biopsy; 44021 requires actual decompression.
No office rate
Choose 44050 when the operation reduces an obstruction. Choose 44021 when the documented service is decompression of the small bowel.
No office rate
44005 describes freeing bowel adhesions. It does not describe decompression, though both procedures may be performed during the same operation.
Compare 44021 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$996.16
Virginia →
Office / nonfacility
Unavailable
Facility
$865.78
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44021 billing questions
How is this different from small-bowel exploration?
Report decompression when the surgeon actively releases gas or intestinal contents from the small bowel. Inspection or exploration without decompression is a different service.
Can the enterotomy used for decompression be reported separately?
No separate incision code is supported when the enterotomy is the means of performing the decompression; it is included in this service.
Should modifier 50 be used for decompression of multiple bowel segments?
No. Modifier 50 is inappropriate for this code; the anatomy and service do not call for bilateral reporting.
What global-period care is included?
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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and 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.
5,32544010,,Incision of small bowel,A,,13.90,6.89,NA,6.89,,2.64,23.43,23.43,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32644015,,Insert needle cath bowel,A,,2.55,0.62,NA,0.62,,0.62,3.79,3.79,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32744020,,Explore small intestine,A,,15.81,7.56,NA,7.56,,4.03,27.40,27.40,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32844021,,Decompress small bowel,A,,15.90,7.35,NA,7.35,,3.96,27.21,27.21,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32944025,,Incision of large bowel,A,,16.10,7.50,NA,7.50,,3.93,27.53,27.53,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33044050,,Reduce bowel obstruction,A,,15.13,7.39,NA,7.39,,3.87,26.39,26.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,33144055,,Correct malrotation of bowel,A,,24.99,9.92,NA,9.92,,6.34,41.25,41.25,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00