CPT 44130 Intestinal Anastomosis Reimbursement | OpenPayer

Summary & Overview

CPT 44130: Intestinal Anastomosis, With or Without Stoma

CPT code 44130 denotes a surgical intestinal anastomosis procedure in which a clinician connects two segments of bowel, with the option of creating a stoma. This code captures a common component of colorectal and general abdominal surgery and is used across inpatient and outpatient surgical settings. Nationally, accurate coding for 44130 matters for appropriate case mix reporting, resource allocation, and surgical quality measurement.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, common billing modifiers associated with surgical services, and national payer coverage considerations. The publication outlines benchmark metrics and policy-relevant notes that affect claims adjudication and hospital reporting. Additionally, the content will clarify coding scope and identify areas where coding variation commonly occurs.

This resource is intended for revenue cycle professionals, surgical coders, clinical administrators, and policy analysts seeking a national-level briefing on CPT code 44130 and its implications for billing and surgical service classification.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44130intestinal anastomosisbowel surgerygeneral surgeryinpatient surgeryambulatory surgery centersurgical codingprocedure coding

Billing Code Overview

CPT code 44130 describes a surgical procedure in which the provider creates an anastomosis between two segments of the intestines. The procedure may be performed with or without bringing a segment of intestine to the skin to create a stoma.

Service type: Intestinal anastomosis / bowel resection-related anastomosis surgery
Typical site of service: Hospital operating room or inpatient surgical suite; may also occur in an ambulatory surgical center when clinically appropriate

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 64-year-old patient with a history of colorectal cancer undergoes segmental small bowel resection with creation of an intestinal anastomosis. The patient presents preoperatively with an obstructing left-sided colon tumor causing subacute bowel obstruction and failure of conservative management. Preoperative workflow includes surgical evaluation, imaging (CT abdomen/pelvis), bowel preparation as indicated, informed consent, pre-anesthesia assessment, and perioperative antibiotic prophylaxis. Intraoperative workflow: laparotomy or laparoscopic exploration, resection of the diseased bowel segment, hemostasis, creation of a primary end-to-end or side-to-side intestinal anastomosis using staples or hand-sewn technique, assessment of anastomotic perfusion, and optional formation of a diverting stoma if indicated. Postoperative workflow: recovery in PACU, inpatient monitoring for return of bowel function, pain control, DVT prophylaxis, wound care, and discharge planning with follow-up for pathology and possible adjuvant therapy.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s professional component for separately payable technical services related to the procedure (rare for operative CPT).
`50`

CPT 44137: Small Intestine Graft Explantation

CPT-44133-LIVING-DONOR-INTESTINAL-HARVEST-WITH-ANASTOMOSIS

CPT 44133: Living-Donor Intestinal Harvest with Primary Anastomosis

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

CPT 44139: Splenic Flexure Mobilization During Colectomy

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

CPT 44111: Excision of Intestinal Lesions, Multiple Incisions

CPT-44125-SMALL-INTESTINE-RESECTION-WITH-STOMA-CREATION

CPT 44125: Small Intestine Resection with Stoma Creation

CPT-44141-COLON-RESECTION-WITH-CECOSTOMY-OR-COLOSTOMY

CPT 44141: Colon Resection with Skin-Level Cecostomy or Colostomy

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

CPT 44128: Small Bowel Resection and Anastomosis for Congenital Atresia

CPT-44147-COLON-RESECTION-OPEN-ABDOMINAL-AND-ANAL-APPROACH

CPT 44147: Colon Resection, Open Abdominal and Anal Approach

CPT-44157-TOTAL-PROCTOCOLECTOMY-ILEOANAL-ANASTOMOSIS

CPT 44157: Total Proctocolectomy with Ileoanal Anastomosis

CPT-44100-SMALL-INTESTINE-CAPSULE-BIOPSY

CPT 44100: Small Intestine Biopsy via Oral Capsule

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Taxonomy Code	Specialty	Notes
208100000X	General Surgery	Most common specialty performing intestinal anastomosis.
2080P0800X	Colon and Rectal Surgery	Specialists who frequently perform colorectal resections and anastomoses.
207L00000X	Vascular Surgery	Occasionally involved when combined vascular procedures are necessary or in complex reoperative abdomen.
208000000X	Surgical Oncology	Surgeons focusing on oncologic bowel resections and complex anastomotic planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K57.20`	Diverticulitis of large intestine with perforation and abscess without bleeding	Perforated diverticulitis often necessitates resection and anastomosis or stoma formation.
`K57.32`	Diverticulitis of large intestine with perforation and abscess, recurrent	Recurrent complicated diverticulitis is an indication for elective resection with anastomosis.
`C18.7`	Malignant neoplasm of sigmoid colon	Colon cancer commonly requires segmental resection with primary anastomosis.
`K56.6`	Other and unspecified intestinal obstruction	Obstruction from strictures or masses may require resection and anastomosis.
`K63.5`	Polyp of colon	Large or unresectable polyps may necessitate segmental resection and anastomosis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44140`	Colectomy, partial; with anastomosis	Typical alternative or adjacent code when the resection involves the colon with primary anastomosis.
`44204`	Laparoscopy, surgical; colectomy, partial, with anastomosis	Minimally invasive approach to partial colectomy that may be performed instead of open `44130` when appropriate.
`44125`	Colectomy, partial; with removal of terminal ileum with ileocolostomy	Related when resection includes terminal ileum with ileocolic anastomosis, often part of same surgical episode.
`44625`	Enterectomy, resection of small intestine with anastomosis	Related small bowel resection and anastomosis codes that may be selected when small intestine (rather than colon) is the primary site.
`43760`	Revision of gastroenterostomy	Performed when revision of prior intestinal anastomosis is required; relevant for reoperative cases.

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