Summary & Overview
CPT 44111: Excision of Intestinal Lesions, Multiple Incisions
CPT code 44111 represents excision of one or more lesions from the small or large intestine using multiple incisions without creation of an anastomosis, fistula, or exteriorization of the bowel. This surgical code is important nationally because it captures a discrete operative intervention for focal intestinal pathology — such as isolated tumors, polyps not amenable to endoscopic removal, or localized benign lesions — and supports appropriate tracking of surgical utilization and reimbursement for inpatient and outpatient surgical settings. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of 44111, national benchmarking and utilization considerations where available, common administrative and coding implications, and a summary of how this code fits within broader surgical service lines. The content clarifies the procedure scope, typical sites of service, and what to expect in billing workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 44111 describes a surgical procedure in which the provider excises one or more lesions from the affected portion of the small or large intestine using multiple incisions. The operation is limited to lesion excision and does not include creation of an anastomosis, formation of a fistula, or exteriorization of the intestine through the skin.
Service type: Surgical excision of intestinal lesions (open or limited incision technique)
Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical complexity and patient factors. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old presenting with intermittent abdominal pain, occult GI bleeding, or anemia and imaging or endoscopy identifies one or more discrete benign-appearing or suspicious lesions localized to the small or large intestine. After preoperative evaluation and informed consent, the patient is scheduled for an operative segmental excision of lesions (enterotomy or small colotomy with multiple lesion excisions) without bowel resection requiring anastomosis or creation of a stoma. The procedure is performed in an operating room or ambulatory surgery setting under general anesthesia with standard perioperative antibiotics and venous thromboembolism prophylaxis. Intraoperative steps include laparotomy or laparoscopy to expose the affected segment, palpation or intraoperative endoscopy as needed to localize lesions, multiple enterotomies or colotomy incisions to excise lesions, inspection for hemostasis, and closure of the intestinal incisions without exteriorizing bowel or creating an anastomosis. Postoperative workflow includes recovery room monitoring, pain control, diet advancement as tolerated, wound checks, pathology submission of excised tissue, and follow-up for pathology results and further oncologic management if indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; only when no other modifier applies and payer accepts this placeholder |
11 | Primary or first-listed procedure | When 44111 is the primary procedure on the claim |
22 | Increased procedural services | When work or complexity substantially exceeds typical for 44111 (document rationale) |
23 | Unusual anesthesia | When procedure requires general anesthesia in patient with documented difficulty or higher anesthetic risk |
26 | Professional component | When reporting separately measurable professional interpretation component (rare for intraoperative excision) |
50 | Bilateral procedure | When identical lesions are excised in bilateral anatomic paired sites (applicable only if coding rules permit) |
51 | Multiple procedures | When 44111 is billed with other distinct procedures during same operative session |
52 | Reduced services | When the procedure is started but not completed or is intentionally reduced in scope |
53 | Discontinued procedure | When the procedure is terminated due to extenuating circumstances after initiation |
54 | Surgical care only | When another clinician bills for pre- and post-operative care separately from the intraoperative surgeon |
55 | Postoperative management only | When the surgeon provides only postoperative care for 44111 |
58 | Staged or related procedure by the same physician during the postoperative period | When a planned second-stage excision is performed after the initial 44111 |
59 | Distinct procedural service | When a separate, distinct procedural service is performed at a separate site or session and must be distinguished from 44111 |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
408600000X | General Surgery | Most common specialty performing intestinal lesion excisions |
208800000X | Colon & Rectal Surgery (Proctology) | Frequently performs colonic lesion excisions and lesion-sparing operations |
363L00000X | Surgical Oncology | Performs excisions when lesions are malignant or suspicious for malignancy |
207P00000X | Gastroenterology | May assist with intraoperative endoscopic localization; not primary surgical provider |
1744C0002X | Pediatric Surgery | Performs similar procedures in pediatric patients when indicated |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K57.20 | Diverticulosis of large intestine without perforation or abscess | Small localized lesions or diverticular-associated lesions may be excised if symptomatic |
K63.5 | Polyp of colon | Common indication for excision of one or more colonic lesions when endoscopic removal is not feasible |
K63.1 | Ileus of intestine (obstruction not specified) | Lesion excision may be required to relieve partial obstruction caused by intraluminal lesions |
K92.2 | Gastrointestinal hemorrhage, unspecified | Lesions causing bleeding may be surgically excised when endoscopic control fails |
D12.6 | Benign neoplasm of colon, unspecified | Benign tumors that require local excision without bowel resection |
C18.9 | Malignant neoplasm of colon, unspecified | Suspicious or malignant lesions may be excised for diagnosis or palliation when limited excision is appropriate |
K29.2 | Gastritis and duodenitis, chronic (if small intestinal involvement) | Rarely relevant; included when mucosal lesions in proximal small bowel are targeted |
R19.5 | Other fecal abnormality | Occult bleeding or abnormal stool prompting diagnostic and therapeutic excision of lesions |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
44120 | Enterectomy, resection of small intestine; single resection and anastomosis | Performed when lesion requires segmental bowel resection with anastomosis rather than limited excision |
44140 | Colectomy, partial; with anastomosis | Performed when broader colonic resection with anastomosis is required instead of lesion excision |
44204 | Laparoscopy, surgical; colectomy, partial, with anastomosis | Minimally invasive alternative when resection and anastomosis are required |
47562 | Laparoscopy, surgical; cholecystectomy (for concurrent procedures) | Example of an additional abdominal procedure that might be billed during the same operative session when indicated |
43235 | Esophagogastroduodenoscopy, flexible, diagnostic, including collection of specimen(s) by brushing or washing, when performed | Intraoperative endoscopy for localization or biopsy adjunct to 44111 |
88305 | Level IV surgical pathology, gross and microscopic examination | Pathology billing for examination of excised intestinal lesions |