Billing code 44203: Small bowel resectionMedicare rate & RVUs in Washington
Report 44203 for each additional laparoscopic small-intestine resection with anastomosis beyond the primary resection, together with 44202.
CMS doesn’t publish an office rate for 44203 in Washington.
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 44203 covers
Code 44203 captures an additional laparoscopic resection and reconnection of small intestine during the same operative session as the primary small-bowel resection. Multiple separate diseased segments, such as skip areas of Crohn disease or separate ischemic segments, may require additional resections and anastomoses. General and colorectal surgeons typically perform this work in an operating room using laparoscopic access.
Report 44203 only with the primary procedure, 44202. Count additional resection-and-anastomosis work, not the length of bowel removed or the number of pathology specimens. The operative report should identify the laparoscopic approach and describe each additional small-bowel segment resected and reconstructed. CMS classifies 44203 as an add-on code: it is billed only with a primary procedure, and payment is within that procedure’s global period.
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 44203 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $211.34 |
| Seattle (King Cnty) | Unavailable | $224.91 |
How the 44203 rate is calculated
Each of 44203’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 · 44203
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.33Practice expense 1.07Malpractice 1.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44203
The CMS indicators that decide how 44203 is paid alongside other services.
CMS payment indicators · 44203
Small bowel resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
44203 without 80 · national facility
$216.10
Small bowel resection
44203-80 · Assistant: 16%
$34.58
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
44203 compared with similar codes
Compare codes
44203 vs 44202 vs 44121 vs 44204: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44202Small bowel resection
- 44202 reports the primary laparoscopic small-bowel resection and anastomosis. Use 44203 only for additional resection-and-anastomosis work in the same operative session.
- 44121Small bowel resection
- 44121 describes additional small-intestine resection and anastomosis using an open approach. Code 44203 is for additional work performed laparoscopically.
- 44204Partial colectomy
- 44204 concerns laparoscopic partial colectomy involving the large intestine. Code 44203 applies to additional small-intestine resection and anastomosis.
44203 billing questions
When is 44203 reported instead of 44202?
44202 represents the primary laparoscopic small-bowel resection with anastomosis. Report 44203 for each additional resection and anastomosis performed in that operative session.
Can 44203 be billed by itself?
No. It is an add-on code and must be reported with the primary procedure, 44202.
Are units based on bowel length or specimen count?
No. The code describes additional resection-and-anastomosis work. The operative report should support each additional resection and reconstruction.
What documentation supports an additional unit?
Document the laparoscopic approach, the additional small-bowel segment removed, and the anastomosis performed for that segment.
How does the global-period payment rule affect 44203?
CMS pays this add-on within the primary procedure’s global period. It is not billed apart from the qualifying primary procedure.
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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