CPT 44136 Small Bowel Reconstruction Reimbursement | OpenPayer

Summary & Overview

CPT 44136: Small Bowel Reconstruction Using Living-Donor Intestine

CPT code 44136 represents a complex surgical intestinal reconstruction in which a recipient’s diseased segment of small bowel is transected and continuity is restored using intestine from a living donor. This procedure is clinically significant because it addresses severe small-bowel pathology or short-bowel syndromes where conventional resection and anastomosis are insufficient, and it often appears in tertiary-care and transplant center workflows.

Key national payers included in the accompanying analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the common modifiers associated with billing for this procedure. The publication also summarizes benchmark payment insights, utilization patterns across major payers, and notable policy or coverage trends affecting access and authorization for complex intestinal reconstructive surgery.

This resource is intended for hospital billing departments, transplant program administrators, and policy analysts seeking a clear, national-level reference for coding and payer considerations related to CPT code 44136. Data not available in the input is noted where specific payer rates, taxonomies, or ICD-10 pairings are required for deeper operational detail.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44136small bowel surgeryintestinal transplantinpatient surgerytransplant billingsurgical anastomosisreconstructive surgery

Billing Code Overview

CPT code 44136 describes a surgical procedure in which the surgeon transects the affected portion of the recipient’s small bowel and uses intestine from a living donor to restore continuity of the recipient’s small intestine. This is a transplant-related intestinal reconstruction involving autologous anastomosis with living-donor intestinal tissue.

Service Type: Small bowel resection with living-donor intestinal interposition (intestinal transplant/reconstruction)
Typical Site of Service: Inpatient hospital, operating room, and associated transplant unit

Clinical & Coding Specifications

Clinical Context

A typical patient for 44136 is an adult who presents with irreversible small bowel disease localized to a segment requiring resection and immediate reconstruction with a living-donor intestinal graft. A realistic scenario: a 45-year-old patient with chronic mesenteric ischemia complicated by segmental small bowel infarction and short bowel physiology after prior resections, who has a living intestinal donor (related living donor) available for segmental intestinal transplantation. The clinical workflow includes preoperative evaluation (nutritional optimization, infectious disease clearance, immunologic crossmatch), coordination with the living donor team, operative planning with transplant and gastrointestinal surgeons, intraoperative small bowel transection of the diseased recipient segment, harvest/implantation of the living-donor intestinal segment, creation of enteric anastomoses to restore continuity, intraoperative hemostasis and drainage, and postoperative care in a transplant or surgical intensive care unit with immunosuppression initiation and close graft monitoring. Typical site of service is an inpatient tertiary care center or transplant hospital with operating room and intensive care availability. Usual providers involved include transplant surgeons, general surgery, anesthesiology, transplant coordinators, and specialized nursing staff.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier

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

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

CPT 44130: Intestinal Anastomosis, With or Without Stoma

CPT-44145-PARTIAL-COLECTOMY-COLORECTAL-ANASTOMOSIS

CPT 44145: Partial Colectomy with Colorectal Anastomosis

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

CPT 44144: Colon Resection with Colostomy and Mucous Fistula

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

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

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

CPT 44128: Small Bowel Resection and Anastomosis for Congenital Atresia

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

CPT 44146: Low Anterior Resection with Colostomy

CPT-44150-TOTAL-COLECTOMY-ILEOSTOMY-OR-ILEORECTAL-ANASTOMOSIS

CPT 44150: Total Colectomy with Ileostomy or Ileorectal Anastomosis

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

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

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

CPT 44120: Small Intestine Resection with Primary Anastomosis

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Taxonomy Code	Specialty	Notes
208000000X	General Surgery	Transplant and complex abdominal surgery management
2086S0126X	Transplant Surgery	Specialized living-donor intestinal transplant surgeons
2084P0800X	Critical Care Medicine	Postoperative ICU management of transplant patients
207L00000X	Anesthesiology	Perioperative anesthesia and intraoperative management
333600000X	Infectious Disease	Pre- and post-transplant infection management and prophylaxis

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K55.0`	Acute vascular disorders of intestine	May cause segmental ischemia requiring resection and grafting
`K55.1`	Chronic vascular disorders of intestine	Chronic mesenteric ischemia leading to progressive bowel loss and need for reconstruction
`K91.82`	Postprocedural intestinal obstruction	Complications or sequelae prompting reconstructive transplant interventions
`K91.83`	Short bowel syndrome (postprocedural)	Indication for intestinal transplantation or grafting due to insufficient absorptive length
`K57.30`	Diverticulosis of small intestine without perforation or abscess	Localized disease that may lead to resection and reconstruction when complicated
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct (example metastatic disease)	Metastatic intestinal tumors with local complications sometimes necessitate segmental resections; included as possible complex surgical context
`T81.2XXA`	Accidental puncture and laceration during a procedure, initial encounter	Represents intraoperative complications that can lead to additional reconstructive surgery

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44136`	Transection and anastomosis of small intestine with living-donor intestinal graft (described)	Primary procedure restoring continuity using living-donor intestine
`44120`	Enterectomy, resection of small intestine; single resection and anastomosis	May be performed for additional recipient small bowel resections during the same operative session
`44140`	Colectomy, partial; with anastomosis	Performed if concurrent colonic resection or reconstruction is required during complex abdominal surgery
`47562`	Liver transplant, living donor, surgical removal of donor liver segment (partial)	Related in multi-organ living-donor transplant programs where coordinated donor procedures occur (team coordination)
`76930`	Ultrasound, surgical, intraoperative	Commonly used intraoperatively for graft assessment or vascular flow evaluation during implantation
`43770`	Pancreas transplant, with or without enteric/exocrine drainage	Listed as related transplant procedures performed in similar transplant centers and may be performed in combined transplant scenarios

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