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CPT 44050: Open Intestinal Repair for Twisted, Telescoped, or Herniated Bowel

CPT code 44050 represents an open surgical incision and repair of the intestine to correct mechanical bowel problems such as volvulus (twisting), intussusception (telescoping), or herniation, excluding procedures on the rectum. This code is used for operative management of acute or chronic intestinal obstruction and related anatomic disruptions that require direct surgical correction. Nationally, accurate coding for these procedures is important for clinical documentation, hospital billing, resource allocation, and quality tracking of acute surgical care.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this open intestinal repair is reported, the typical sites of service where it occurs, and common billing considerations that affect claims processing. The publication provides benchmarks for utilization and payment patterns where available, summarizes relevant policy updates that influence coverage and coding practice, and clarifies the service definition to support consistent documentation. Data not available in the input will be identified where applicable.

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Billing Code Overview

CPT code 44050 describes a surgical procedure in which the provider makes an incision in the affected portion of the intestine to repair a twisted, telescoped, or herniated bowel (excluding the rectum). This procedure is a form of open intestinal repair for mechanical complications of the bowel.

Service type: Surgical repair of small or large intestine for obstruction or mechanical displacement (open abdominal procedure)
Typical site of service: Hospital operating room or inpatient surgical setting

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CPT 44050: Open Intestinal Repair for Twisted, Telescoped, or Herniated Bowel

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Get alerted when payer policies referencing 44050 are released or updated.

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Billing Code Overview

Service type: Surgical repair of small or large intestine for obstruction or mechanical displacement (open abdominal procedure)
Typical site of service: Hospital operating room or inpatient surgical setting

Clinical & Coding Specifications

Clinical Context

A 48-year-old male presents to the emergency department with sudden onset severe abdominal pain, progressive abdominal distention, nausea, and vomiting. Vital signs show tachycardia and low-grade fever. Abdominal exam reveals localized tenderness with signs of obstruction. Abdominal radiographs and CT scan demonstrate a segmental small bowel volvulus with evidence of compromised bowel and obstruction. The patient is taken to the operating room for exploratory laparotomy and operative management. The surgeon performs an enterotomy and repair to correct the twisted and obstructed segment of small intestine, preserving viable bowel when possible. Intraoperative documentation includes indication (volvulus/torsion), location of the incision on the affected intestine, findings (ischemia vs viable bowel), procedures performed (reduction of volvulus, enterotomy/enterostomy for repair), and whether bowel resection or anastomosis was required.

Typical workflow: triage and resuscitation in ED, diagnostic imaging (abdominal X-ray/CT), preoperative consent, general anesthesia, operative intervention with incision into the affected intestine for reduction and repair, postoperative monitoring in PACU or ICU as indicated, and inpatient recovery with serial abdominal exams and return of bowel function before discharge.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased Procedural Services	When the work, time, and technical difficulty substantially exceed typical for `44050` due to dense adhesions or unexpected complexity.
`23`	Unusual Anesthesia	When general or regional anesthesia is medically contraindicated and an unusual anesthesia circumstance is required.
`52`	Reduced Services	When the procedure is partially reduced or aborted but still performed to a limited extent.
`53`	Discontinued Procedure	When the procedure is started but halted due to extenuating circumstances or patient safety before completion.
`62`	Two Surgeons	When two surgeons with distinct skills perform portions of the operation simultaneously or sequentially.
`76`	Repeat Procedure by Same Physician	Data not available in the input.
`78`	Unplanned Return to OR by Same Physician Following Initial Procedure for a Related Procedure	When the patient requires an unplanned return to the OR for complications related to the initial `44050` repair.
`79`	Unrelated Procedure or Service by Same Physician During Postoperative Period	When a separate unrelated surgery is performed during the postoperative global period.
`59`	Distinct Procedural Service	When a separate, distinct procedural service is performed at a different site or session from `44050`.
`62`	Two Surgeons	When two surgeons are required for complex reduction and repair (listed again for emphasis on applicability).

Taxonomy Code	Specialty	Notes
207P00000X	General Surgery	Most common specialty performing intestinal incision and repair for volvulus or intussusception.
207L00000X	Colon and Rectal Surgery	Performs complex bowel repairs, particularly when colorectal segments are involved.
2080P0003X	Acute Care Surgery	Surgeons who commonly manage emergent bowel obstruction and perform operative repairs.
207T00000X	Pediatric Surgery	Performs analogous procedures in pediatric patients with intussusception or volvulus.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K56.2`	Volvulus	Classic indication for operative incision and repair of twisted intestine as described by `44050`.
`K56.1`	Intussusception	Telescoping of bowel requiring reduction and possible enterotomy/repair.
`K56.69`	Other intestinal obstruction	General obstruction codes that may lead to surgical enterotomy for relief and repair.
`K63.2`	Fistula of intestine	May necessitate incision and repair when associated with localized bowel pathology.
`K55.0`	Acute vascular disorders of intestine (mesenteric ischemia)	When ischemia results in compromised bowel and limited enterotomy or repair is performed if resection not required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterolysis (separation of adhesions) with or without biopsy, small intestine	Performed when dense adhesions contribute to obstruction or when adhesiolysis is required in addition to the incision and repair.
`44160`	Bowel resection, partial; small intestine	Performed when the affected intestinal segment is nonviable and resection with anastomosis is required instead of primary repair.
`44202`	Laparoscopy, surgical; enterolysis	Minimally invasive approach when feasible; may be performed before conversion to open `44050` if adhesions or ischemia are identified.
`49010`	Insertion of temporary intraperitoneal drain	Performed postoperatively when contamination or risk of intra-abdominal collection necessitates drainage following enterotomy or repair.
`47562`	Laparoscopic cholecystectomy	Data not available in the input.

CPT 44005: Lysis of Adhesions, Colon and Intra‑abdominal Structures

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

CPT 44010: Exploratory Abdominal Surgery with Duodenal Examination

CPT-44015-JEJUNOSTOMY-FEEDING-TUBE-PLACEMENT

CPT 44015: Jejunostomy Feeding Tube Placement

CPT-44020-GASTROINTESTINAL-SURGICAL-PROCEDURE

CPT 44020: Gastrointestinal Surgical Procedure

CPT-44021-SMALL-BOWEL-EXPLORATION-DECOMPRESSION

CPT 44021: Small Bowel Exploration and Decompression Procedure

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

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

CPT-44055-DEROTATION-LYSIS-INTESTINAL-MALROTATION

CPT 44055: Open Surgical Derotation and Lysis of Intestinal Malrotation

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased Procedural Services	When the work, time, and technical difficulty substantially exceed typical for `44050` due to dense adhesions or unexpected complexity.
`23`	Unusual Anesthesia	When general or regional anesthesia is medically contraindicated and an unusual anesthesia circumstance is required.
`52`	Reduced Services	When the procedure is partially reduced or aborted but still performed to a limited extent.
`53`	Discontinued Procedure	When the procedure is started but halted due to extenuating circumstances or patient safety before completion.
`62`	Two Surgeons	When two surgeons with distinct skills perform portions of the operation simultaneously or sequentially.
`76`	Repeat Procedure by Same Physician	Data not available in the input.
`78`	Unplanned Return to OR by Same Physician Following Initial Procedure for a Related Procedure	When the patient requires an unplanned return to the OR for complications related to the initial `44050` repair.
`79`	Unrelated Procedure or Service by Same Physician During Postoperative Period	When a separate unrelated surgery is performed during the postoperative global period.
`59`	Distinct Procedural Service	When a separate, distinct procedural service is performed at a different site or session from `44050`.
`62`	Two Surgeons	When two surgeons are required for complex reduction and repair (listed again for emphasis on applicability).

Taxonomy Code	Specialty	Notes
207P00000X	General Surgery	Most common specialty performing intestinal incision and repair for volvulus or intussusception.
207L00000X	Colon and Rectal Surgery	Performs complex bowel repairs, particularly when colorectal segments are involved.
2080P0003X	Acute Care Surgery	Surgeons who commonly manage emergent bowel obstruction and perform operative repairs.
207T00000X	Pediatric Surgery	Performs analogous procedures in pediatric patients with intussusception or volvulus.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K56.2`	Volvulus	Classic indication for operative incision and repair of twisted intestine as described by `44050`.
`K56.1`	Intussusception	Telescoping of bowel requiring reduction and possible enterotomy/repair.
`K56.69`	Other intestinal obstruction	General obstruction codes that may lead to surgical enterotomy for relief and repair.
`K63.2`	Fistula of intestine	May necessitate incision and repair when associated with localized bowel pathology.
`K55.0`	Acute vascular disorders of intestine (mesenteric ischemia)	When ischemia results in compromised bowel and limited enterotomy or repair is performed if resection not required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterolysis (separation of adhesions) with or without biopsy, small intestine	Performed when dense adhesions contribute to obstruction or when adhesiolysis is required in addition to the incision and repair.
`44160`	Bowel resection, partial; small intestine	Performed when the affected intestinal segment is nonviable and resection with anastomosis is required instead of primary repair.
`44202`	Laparoscopy, surgical; enterolysis	Minimally invasive approach when feasible; may be performed before conversion to open `44050` if adhesions or ischemia are identified.
`49010`	Insertion of temporary intraperitoneal drain	Performed postoperatively when contamination or risk of intra-abdominal collection necessitates drainage following enterotomy or repair.
`47562`	Laparoscopic cholecystectomy	Data not available in the input.

CPT 44005: Lysis of Adhesions, Colon and Intra‑abdominal Structures

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

CPT 44010: Exploratory Abdominal Surgery with Duodenal Examination

CPT-44015-JEJUNOSTOMY-FEEDING-TUBE-PLACEMENT

CPT 44015: Jejunostomy Feeding Tube Placement

CPT-44020-GASTROINTESTINAL-SURGICAL-PROCEDURE

CPT 44020: Gastrointestinal Surgical Procedure

CPT-44021-SMALL-BOWEL-EXPLORATION-DECOMPRESSION

CPT 44021: Small Bowel Exploration and Decompression Procedure

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

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

CPT-44055-DEROTATION-LYSIS-INTESTINAL-MALROTATION

CPT 44055: Open Surgical Derotation and Lysis of Intestinal Malrotation

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 44050: Open Intestinal Repair for Twisted, Telescoped, or Herniated Bowel

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Billing Code Overview

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CPT 44050: Open Intestinal Repair for Twisted, Telescoped, or Herniated Bowel

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 44050: Open Intestinal Repair for Twisted, Telescoped, or Herniated Bowel

Sign up for cpt 44050 policy alerts

Billing Code Overview

CPT 44050: Open Intestinal Repair for Twisted, Telescoped, or Herniated Bowel

Sign up for cpt 44050 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 44050 represent and when is it typically used?

Which modifiers are applicable to CPT 44050 and when should they be considered?

What related CPT codes might be reported alongside or instead of 44050 and in what situations?

Which ICD-10 diagnosis codes are commonly associated with procedures coded as 44050?

Which specialties commonly perform CPT 44050?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 44050 represent and when is it typically used?

Which modifiers are applicable to CPT 44050 and when should they be considered?

What related CPT codes might be reported alongside or instead of 44050 and in what situations?

Which ICD-10 diagnosis codes are commonly associated with procedures coded as 44050?

Which specialties commonly perform CPT 44050?

References