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    v1.0.30
    OpenPayerBilling CodesIncision Procedures on the Intestines (Except Rectum)CPT cpt-44020-gastrointestinal-surgical-procedure
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    CPT 44020: Enterolysis (Adhesiolysis) of Small Intestine

    Medicare pays $922 on average nationally for this procedure.

    CPT code 44020 describes surgical enterolysis or adhesiolysis of the abdomen performed through laparotomy or laparoscopy to free intestinal adhesions and restore bowel function; this operative procedure is a general surgery service typically provided in an operating room or ambulatory surgery center under general anesthesia and is used when adhesions cause obstruction, pain, or impaired motility.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 58-year-old with chronic symptomatic peptic strictures or small bowel obstruction due to Crohn disease presenting with progressive nausea, vomiting, abdominal pain, and inability to tolerate oral intake. After imaging confirms a localized small-bowel or gastric outlet obstruction amenable to endoscopic management, the patient is scheduled for an exploratory laparotomy with small bowel resection and primary anastomosis. Preoperative workflow includes surgical consent, anesthesia evaluation, NPO status, appropriate perioperative antibiotics, and bowel preparation as indicated. Intraoperative steps involve midline laparotomy, identification of the obstructed segment, mobilization, resection of the diseased bowel, and creation of a hand-sewn or stapled end-to-end or side-to-side anastomosis. Postoperative care includes monitoring in PACU, pain control, early ambulation, bowel function assessment, and discharge planning with outpatient follow-up for wound and nutrition management. The procedure is typically performed in an inpatient hospital operating room under general anesthesia by a general surgeon with possible assistance from an attending or surgical first assist.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    44120Small intestine resection, with anastomosis, for disease (eg, Crohn disease)Alternative or related code when the resection is limited to a segment of small intestine and coded specifically by approach and complexity.
    44160Enterolysis (separate procedure)Performed when extensive adhesiolysis is required prior to resection or to relieve obstruction.
    44202Laparoscopy, surgical; colectomy, partial, with anastomosisRelated minimally invasive approach for bowel resection when laparoscopic technique is used instead of open laparotomy.
    43840Excision of small intestine tumor; segmental resection with anastomosisUsed when the indication for resection is a localized neoplasm rather than benign disease.
    99223Initial hospital care, high severityTypical inpatient evaluation and management code for the day of major surgery by the admitting surgeon.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    207K00000X
    174400000X
    281P00000X
    204E00000X
    207SG0203X
    364SX0200X
    261QS1000X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    I70.201Unspecified atherosclerosis of native arteries of extremities, right leg
    I70.211Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
    I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg
    I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
    I70.242Atherosclerosis of native arteries of left leg with ulceration of calf
    I70.243Atherosclerosis of native arteries of left leg with ulceration of ankle
    I70.261Atherosclerosis of native arteries of extremities with gangrene, right leg
    I70.291Other atherosclerosis of native arteries of extremities, right leg
    I70.411Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, right leg
    I70.412Atherosclerosis of autologous vein bypass graft(s) of the extremities with intermittent claudication, left leg

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-44005-LYSIS-OF-ADHESIONS-COLON-ABDOMINAL-ADHESIOLYSIS

    CPT 44005: Lysis of Adhesions, Colon and Abdominal Structures

    CPT-44010-EXPLORATORY-ABDOMEN-DUODENUM-EXCISION-BIOPSY-FOREIGN-BODY

    CPT 44010: Exploration of Abdomen with Duodenal Examination

    CPT-44015-JEJUNOSTOMY-FEEDING-TUBE-PLACEMENT

    CPT 44015: Jejunostomy with External Feeding Tube Placement

    CPT-44021-SMALL-BOWEL-EXPLORATION-DECOMPRESSION

    CPT 44021: Incision of Small Intestine and Placement of Decompression Tube

    CPT-44025-COLON-INCISION-EXAMINATION-BIOPSY-REMOVAL-FOREIGN-BODY

    CPT 44025: Colon Incision for Exploration, Biopsy, or Foreign Body Removal

    CPT-44050-OPEN-INTESTINAL-REPAIR-TWISTED-TELESCOPED-HERNIATED-BOWEL

    CPT 44050: Enterotomy for Repair of Twisted/Telescoped/Herniated Bowel

    CPT-44055-DEROTATION-LYSIS-INTESTINAL-MALROTATION

    CPT 44055: Lysis of Intestinal Malrotation and Derotation

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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