Summary & Overview

CPT 44137: Small Intestine Graft Explantation

CPT code 44137 denotes the surgical identification and complete removal (explantation) of a small intestine graft. This code is used when a provider surgically removes an implanted small intestine graft due to complications, graft failure, or clinical necessity. It represents a specialized surgical service with implications for perioperative care, graft registry reporting, and transplant program operations. Nationally, accurate use of this code supports billing clarity, quality measurement, and resource planning for transplant and complex abdominal surgery programs.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coding purpose and clinical context, payer coverage considerations, and the types of benchmarks and policy issues commonly associated with complex graft explantation services. The publication outlines expected sites of service, typical clinical scenarios prompting explantation, and the administrative coding considerations that affect billing and claims processing. Where specific input data is missing, the report notes that information is not available in the input. The focus is national in scope and intended for coding professionals, clinical program managers, and health policy analysts seeking concise guidance on CPT code 44137.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44137small intestine graftgraft explantationtransplant surgerysurgical proceduresoperating room servicesbilling and codingcode description

Billing Code Overview

CPT code 44137 describes the identification and complete removal of a small intestine graft from a patient. This procedure involves surgically explanting an implanted small intestine graft that is no longer required or is failing.

Service type: Surgical explantation of small intestine graft
Typical site of service: Operating room or specialized surgical suite in an inpatient or ambulatory surgical center, depending on clinical status and perioperative needs

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient with a history of small bowel transplantation presents for planned explantation of a failed small intestine graft due to chronic rejection and recurrent severe complications (recurrent infection and graft dysfunction). Preoperative evaluation includes transplant surgery assessment, review of immunosuppression regimen, crossmatch/serologic studies, and imaging (CT abdomen) to confirm graft anatomy and adhesions. The operating surgeon, typically a transplant or general surgeon with intestinal transplant experience, performs the procedure in an inpatient operating room under general anesthesia. Intraoperative steps include laparotomy, identification of the transplanted small intestine graft, careful mobilization and control of vascular and enteric anastomoses, complete removal of the graft, hemostasis, and possible formation of enteric stoma or reanastomosis depending on native bowel status. Postoperative care involves intensive monitoring for bleeding, infection, fluid/electrolyte management, and coordination with the transplant team for immune management and potential plans for retransplantation or long-term nutritional support (total parenteral nutrition). Typical site of service is an inpatient hospital operating room. Service type: operative surgical procedure — removal of small intestine graft (44137).

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Standard reporting when no additional modifier applies

Taxonomy Code	Specialty	Notes
2080S0106X	Transplant Surgery	Primary specialty most commonly performing small intestine graft explantation
207RX0400X	General Surgery	General surgeons with complex abdominal surgery experience often perform explantation in centers without dedicated transplant surgery teams
207L00000X	Colon & Rectal Surgery	May be involved when pelvic or lower bowel reconstruction is required after graft removal
2086S0125X	Pediatric Transplant Surgery	When the patient is a pediatric transplant recipient requiring graft explantation
207P00000X	Surgical Oncology	In cases where graft removal is related to malignancy or complex resections involving oncologic concerns

CPT Code	Description	Relationship to This Procedure
`44120`	Enterectomy, resection of small intestine; single resection and anastomosis	Performed when native small bowel resection or reconstruction is required in conjunction with graft removal
`44227`	Laparoscopy, surgical, enterolysis (freeing adhesions)	May be used for minimally invasive lysis of adhesions prior to or instead of open explantation in select cases
`44204`	Laparoscopy, surgical; small intestine, resection, with anastomosis	Minimally invasive approach for bowel resection that can be adjunctive to graft removal where feasible
`49652`	Laparoscopic lysis of adhesions, severe	Adhesiolysis is commonly necessary during graft explantation; this code reflects extensive adhesion work
`44180`	Small bowel resection with anastomosis, extensive; for multiple resections	Used when multiple segments including graft and native bowel require resection and reconstruction
`43760`	Enterostomy, creation of intestinal stoma	May be performed after graft removal if diversion or long-term enteral access is required

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