CPT 44125 Small Intestine Resection Reimbursement | OpenPayer

Summary & Overview

CPT 44125: Small Intestine Resection with Stoma Creation

CPT code 44125 designates a surgical resection of a segment of the small intestine with creation of a stoma by suturing the remaining bowel to the abdominal wall. This operative approach is used for conditions that require removal of diseased small bowel and diversion of intestinal contents to an external stoma for management of obstruction, ischemia, trauma, or other pathology. Nationally, procedures coded with 44125 are significant for surgical resource use, inpatient surgical quality measurement, and post-acute care planning.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, expected site-of-service, and common billing considerations associated with this operative service. The publication covers benchmark metrics and payment context relevant to hospitals and surgical teams, highlights policy updates affecting inpatient surgical claims and documentation standards, and summarizes clinical factors that influence coding and utilization for small bowel resection with stoma creation. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare44125CPTsmall bowel resectionstomaenterostomyinpatient surgerygeneral surgeryoperative procedure

Billing Code Overview

CPT code 44125 describes a surgical procedure in which the surgeon makes an abdominal incision to resect a segment of the small intestine and creates a stoma by suturing the remaining end of small bowel, which is attached to the stomach, to the abdominal wall. This procedure involves removal of a diseased or damaged portion of small intestine and exteriorization of the bowel as a stoma.

Service type: Abdominal small intestine resection with stoma creation (enterostomy/ostomy)

Typical site of service: Inpatient hospital operating room

Clinical & Coding Specifications

Clinical Context

A 64-year-old patient presents with chronic small bowel disease complicated by a non-healing enteric fistula and short bowel syndrome after multiple prior resections. The patient has recurrent malnutrition, high-output intestinal fistula, and sepsis risk. After multidisciplinary review, the surgical team schedules a laparotomy for segmental small bowel resection with formation of an end jejunostomy (stoma) to divert intestinal contents and allow healing and nutritional management. The procedure involves a midline abdominal incision, resection of the diseased small intestine segment, closure of the distal bowel remnant, and maturation of the proximal small bowel to the abdominal wall as a stoma attached to the skin. Perioperative workflow includes preoperative optimization (IV fluids, electrolyte correction, nutritional plan), intraoperative general anesthesia with abdominal exploration, small bowel resection and stoma creation, and immediate postoperative management in the PACU or surgical ward with stoma care teaching, monitoring for anastomotic leak or ischemia, pain control, and early nutrition planning.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no additional modifier applies and payor requires explicit `00` reporting

CPT 44147: Colon Resection, Open Abdominal and Anal Approach

CPT-44140-PARTIAL-COLECTOMY-WITH-PRIMARY-ANASTOMOSIS

CPT 44140: Partial Colectomy with Primary Anastomosis

CPT-44144-COLON-RESECTION-WITH-COLOSTOMY-AND-MUCOUS-FISTULA

CPT 44144: Colon Resection with Colostomy and Mucous Fistula

CPT-44146-LOW-ANTERIOR-RESECTION-WITH-COLOSTOMY

CPT 44146: Low Anterior Resection with Colostomy

CPT-44135-SMALL-BOWEL-TRANSPLANT-WITH-CADAVER-INTESTINE-RECONSTRUCTION

CPT 44135: Small Bowel Transplant with Cadaver Donor Intestine

CPT-44157-TOTAL-PROCTOCOLECTOMY-ILEOANAL-ANASTOMOSIS

CPT 44157: Total Proctocolectomy with Ileoanal Anastomosis

CPT-44139-SPLENIC-FLEXURE-MOBILIZATION-DURING-COLECTOMY

CPT 44139: Splenic Flexure Mobilization During Colectomy

CPT-44126-SMALL-BOWEL-RESECTION-CONGENITAL-ATRESIA-END-TO-END-ANASTOMOSIS

CPT 44126: Small Bowel Resection for Congenital Atresia with End-to-End Anastomosis

CPT-44160-OPEN-RESECTION-TERMINAL-ILEUM-PROXIMAL-COLON-ANASTOMOSIS

CPT 44160: Open Resection of Terminal Ileum and Proximal Colon with Anastomosis

CPT-44100-SMALL-INTESTINE-CAPSULE-BIOPSY

CPT 44100: Small Intestine Biopsy via Oral Capsule

Showing 1–10 of 29

Taxonomy Code	Specialty	Notes
`408600000X`	General Surgery	Most common specialty performing small bowel resection and stoma creation
`207L00000X`	Colon and Rectal Surgery (Proctology)	Often manages complex stoma creation and pelvic-related intestinal disease
`207R00000X`	Surgical Oncology	Performs bowel resections when disease is malignant or part of oncologic management
`208D00000X`	Critical Care Medicine (consultation)	Involved in perioperative management of hemodynamically unstable patients
`208800000X`	Gastroenterology (consult/diagnostic)	Provides preoperative diagnostic evaluation and postoperative nutritional management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K57.20`	Diverticulitis of small intestine without perforation or abscess	Small bowel segment may require resection when complicated by recurrent inflammation or obstruction
`K91.2`	Postoperative intestinal obstruction	May lead to segmental resection and stoma if obstruction is recurrent or causes ischemia
`K63.2`	Fistula of intestine	Enteric fistula often necessitates resection and stoma creation for control and healing
`K55.9`	Vascular disorder of intestine, unspecified	Mesenteric ischemia or infarction can require resection and stoma formation for nonviable bowel
`C17.9`	Malignant neoplasm of small intestine, unspecified	Oncologic resection with proximal stoma may be performed when primary anastomosis is not appropriate

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterectomy, resection of small intestine; single resection and anastomosis	Performed when primary resection with primary anastomosis is feasible instead of stoma formation; alternative operative approach to `44125`
`44625`	Enterostomy, revision of stoma	May be performed later if stoma requires revision for prolapse, retraction, or necrosis after initial `44125`
`43843`	Revision of stoma (small intestine)	Used when formal revision of an existing small bowel stoma is required postoperatively
`49905`	Repair of enterocutaneous fistula, open; small intestine	Performed in cases where fistula takedown/reconstruction occurs alongside or separate from resection and stoma creation
`39501`	Re-exploration of abdomen for hemorrhage/complication	Used when an urgent return to OR is required for postoperative bleed or complication related to the resection/stoma

OpenPayer