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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.

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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

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CPT 44125: Small Intestine Resection with Stoma Creation

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Get alerted when payer policies referencing 44125 are released or updated.

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Billing Code Overview

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
`11`	Principal performance of procedure	Use when the reporting surgeon is the primary surgeon performing the resection and stoma creation
`22`	Increased procedural services	Use when work, time, or complexity significantly exceeds typical for `44125` (e.g., extensive adhesiolysis, hostile abdomen)
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and markedly different/complex anesthesia technique was required
`52`	Reduced services	Use when a planned portion of the procedure was not completed but some portion performed (e.g., aborted resection)
`53`	Discontinued procedure	Use when procedure is started but terminated due to patient instability before completion of resection/stoma creation
`59`	Distinct procedural service	Use when another separately identifiable procedure is performed on the same day at a different site or separate tissue plane (e.g., separate diagnostic laparoscopic procedure converted to open with distinct services)
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the small bowel resection/stoma creation
`66`	Surgical team	Use when a surgical team approach is documented (multiple surgeons performing coordinated roles)
`78`	Return to OR for related procedure during global period	Use when an unplanned return to the operating room for a related procedure (e.g., stoma revision for bleeding) occurs within the global period
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the postoperative period that is not part of the global, such as an unrelated wound incision elsewhere
`AS`	Ambulatory surgery	Use to denote procedures performed in an ambulatory surgical center setting when applicable
`QK`	Medical direction of 2–4 auxiliaries	Use when the surgeon medically directs certified assistants during the procedure (where assistant modifiers are required)
`QX`	Modifier for services performed by a PA	Use when a physician assistant performs part of a billable service under applicable payor rules

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

CPT 44100: Small Intestine Biopsy via Oral Capsule

CPT-44110-OPEN-EXCISION-INTESTINAL-LESION-SINGLE-INCISION

CPT 44110: Open Excision of Intestinal Lesion(s), Single Incision

CPT-44111-INTESTINAL-LESION-EXCISION-MULTIPLE-INCISIONS

CPT 44111: Excision of Intestinal Lesions, Multiple Incisions

CPT-44120-SMALL-INTESTINE-RESECTION-PRIMARY-ANASTOMOSIS

CPT 44120: Small Intestine Resection with Primary Anastomosis

CPT-44121-ADDITIONAL-SMALL-INTESTINE-RESECTION-ANASTOMOSIS

CPT 44121: Additional Small Intestine Resection with Anastomosis

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-44127-SMALL-BOWEL-RESECTION-ANASTOMOSIS-INTESTINAL-ATRESIA

CPT 44127: Small-Bowel Resection with Anastomosis for Intestinal Atresia

CPT-44128-SMALL-BOWEL-RESECTION-ANASTOMOSIS-CONGENITAL-ATRESIA

CPT 44128: Small Bowel Resection and Anastomosis for Congenital Atresia

CPT-44130-INTESTINAL-ANASTOMOSIS-BOWEL-RESECTION-ANASTOMOSIS

CPT 44130: Intestinal Anastomosis, With or Without Stoma

CPT-44132-DONOR-SMALL-BOWEL-RESECTION-PRESERVATION-FOR-TRANSPLANT

CPT 44132: Donor Small Intestine Resection and Cold Preservation

Showing 1–10 of 29

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
`00`	No modifier	Use when no additional modifier applies and payor requires explicit `00` reporting
`11`	Principal performance of procedure	Use when the reporting surgeon is the primary surgeon performing the resection and stoma creation
`22`	Increased procedural services	Use when work, time, or complexity significantly exceeds typical for `44125` (e.g., extensive adhesiolysis, hostile abdomen)
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and markedly different/complex anesthesia technique was required
`52`	Reduced services	Use when a planned portion of the procedure was not completed but some portion performed (e.g., aborted resection)
`53`	Discontinued procedure	Use when procedure is started but terminated due to patient instability before completion of resection/stoma creation
`59`	Distinct procedural service	Use when another separately identifiable procedure is performed on the same day at a different site or separate tissue plane (e.g., separate diagnostic laparoscopic procedure converted to open with distinct services)
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the small bowel resection/stoma creation
`66`	Surgical team	Use when a surgical team approach is documented (multiple surgeons performing coordinated roles)
`78`	Return to OR for related procedure during global period	Use when an unplanned return to the operating room for a related procedure (e.g., stoma revision for bleeding) occurs within the global period
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the postoperative period that is not part of the global, such as an unrelated wound incision elsewhere
`AS`	Ambulatory surgery	Use to denote procedures performed in an ambulatory surgical center setting when applicable
`QK`	Medical direction of 2–4 auxiliaries	Use when the surgeon medically directs certified assistants during the procedure (where assistant modifiers are required)
`QX`	Modifier for services performed by a PA	Use when a physician assistant performs part of a billable service under applicable payor rules

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

CPT 44100: Small Intestine Biopsy via Oral Capsule

CPT-44110-OPEN-EXCISION-INTESTINAL-LESION-SINGLE-INCISION

CPT 44110: Open Excision of Intestinal Lesion(s), Single Incision

CPT-44111-INTESTINAL-LESION-EXCISION-MULTIPLE-INCISIONS

CPT 44111: Excision of Intestinal Lesions, Multiple Incisions

CPT-44120-SMALL-INTESTINE-RESECTION-PRIMARY-ANASTOMOSIS

CPT 44120: Small Intestine Resection with Primary Anastomosis

CPT-44121-ADDITIONAL-SMALL-INTESTINE-RESECTION-ANASTOMOSIS

CPT 44121: Additional Small Intestine Resection with Anastomosis

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-44127-SMALL-BOWEL-RESECTION-ANASTOMOSIS-INTESTINAL-ATRESIA

CPT 44127: Small-Bowel Resection with Anastomosis for Intestinal Atresia

CPT-44128-SMALL-BOWEL-RESECTION-ANASTOMOSIS-CONGENITAL-ATRESIA

CPT 44128: Small Bowel Resection and Anastomosis for Congenital Atresia

CPT-44130-INTESTINAL-ANASTOMOSIS-BOWEL-RESECTION-ANASTOMOSIS

CPT 44130: Intestinal Anastomosis, With or Without Stoma

CPT-44132-DONOR-SMALL-BOWEL-RESECTION-PRESERVATION-FOR-TRANSPLANT

CPT 44132: Donor Small Intestine Resection and Cold Preservation

Showing 1–10 of 29

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.

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CPT 44125: Small Intestine Resection with Stoma Creation

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Billing Code Overview

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CPT 44125: Small Intestine Resection with Stoma Creation

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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