Summary & Overview

CPT 44140: Partial Colectomy with Primary Anastomosis

CPT code 44140 represents a partial colectomy with primary anastomosis — the surgical removal of a segment of the colon followed by reconnection of the remaining ends. This procedure is a common operative approach for conditions such as colonic neoplasia, diverticular disease, ischemia, and other causes of localized colonic pathology, and it has significant implications for hospital surgical throughput, payment policy, and post-operative quality measurement. Nationally, this code matters because it captures a high-acuity inpatient surgical service with substantial resource use and variability in clinical pathways.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how payers classify and reimburse this operative service, typical sites of service, and clinical contexts linked to the code.

Readers will learn: a concise clinical description of the service captured by CPT code 44140; the common care settings and surgical service line; typical payer coverage considerations; and where to find benchmarks, coding guidance, and policy updates relevant to surgical billing and post-operative quality metrics. Data not available in the input will be explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare44140CPTcolorectal-surgerypartial-colectomyanastomosissurgical-procedureinpatient-surgeryambulatory-surgeryhospital-operations

Billing Code Overview

CPT code 44140 describes a surgical partial colectomy with primary anastomosis, in which the provider removes a portion of the colon and then reconnects the cut ends to restore intestinal continuity. This procedure is a surgical service that typically takes place in an inpatient hospital operating room or an ambulatory surgical center depending on clinical complexity and patient status.

Service type: Surgical — General/Colorectal Surgery

Typical site of service: Hospital inpatient operating room or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with symptomatic diverticulitis, colorectal cancer, or obstructing colorectal lesion presenting with abdominal pain, change in bowel habits, bleeding, or obstruction. After preoperative evaluation including history, physical exam, laboratory studies, cross-sectional abdominal imaging (CT abdomen/pelvis), and colonoscopy when feasible, the patient is scheduled for an open segmental colectomy with primary anastomosis. The workflow includes preoperative optimization, informed consent, anesthesia evaluation, intraoperative resection of the diseased colon segment with restoration of continuity by an end-to-end or side-to-side anastomosis, and post-anesthesia recovery. Postoperative care involves monitoring for anastomotic leak, infection, bowel function return, pain control, venous thromboembolism prophylaxis, and discharge planning with follow-up for pathology results and oncologic staging if applicable.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — default billing	Use when no special circumstances apply and no modifier is required.
`22`	Increased procedural services	Use when the colectomy required substantially greater work or complexity than typical, documented in the operative report.
`53`	Discontinued procedure	Use when the planned colectomy was started but discontinued due to intraoperative circumstances.
`54`	Surgical care only	Use when billing only the surgeon's component and another provider bills the pre/postoperative care.
`55`	Postoperative management only	Use when billing only postoperative care; another provider billed the surgery.
`56`	Preoperative management only	Use when billing only preoperative evaluation and decision for surgery.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons, both performing distinct portions.
`66`	Surgical team (multiple surgeons)	Use when a surgical team participates and team modifiers are required by payor policy.
`78`	Unplanned return to OR for related procedure during postoperative period	Use when the patient returns to OR for a complication of the initial colectomy.
`79`	Unrelated procedure or service by same physician during postoperative period	Use when an unrelated procedure is performed during the global period.
`59`	Distinct procedural service	Use when an additional distinct service (e.g., placement of a feeding tube) is performed at a separate site or session.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`66`	Surgical team	Use when the procedure is performed by an organized team under specific payor rules.
`50`	Bilateral procedure	Rarely applicable; use only if bilateral colonic procedures are reported and payor accepts bilateral modifier for abdominal procedures.

Taxonomy Code	Specialty	Notes
208000000X	Colorectal Surgery	Colorectal surgeons frequently perform segmental colectomy with anastomosis.
208800000X	General Surgery	General surgeons commonly perform open or laparoscopic colectomies.
207L00000X	Surgical Oncology	Surgical oncologists perform colectomy for malignancy with oncologic technique.
207K00000X	Colon and Rectal Surgery (alternative taxonomy)	Colorectal subspecialists focusing on colon/rectal disease and anastomotic management.
2086S0122X	Acute Care Surgery	Acute care surgeons manage emergent colectomies for perforation or severe diverticulitis.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K57.32`	Diverticulitis of large intestine with perforation and abscess	Indication for emergent or urgent segmental colectomy with anastomosis or diversion.
`K57.20`	Diverticulitis of large intestine without perforation or abscess	Common elective indication for resection when recurrent or complicated.
`C18.9`	Malignant neoplasm of colon, unspecified	Indication for oncologic colectomy with primary anastomosis when resection is appropriate.
`K63.5`	Polyp of colon	Large or unresectable polyps may necessitate segmental colectomy.
`K91.83`	Anastomotic leak (postprocedural)	Postoperative complication directly related to colectomy and anastomosis.
`K59.0`	Constipation	Symptom that may be associated with obstructing lesions prompting evaluation and resection.
`K56.6`	Other and unspecified intestinal obstruction	Obstruction from colonic lesion can necessitate emergent colectomy.
`K62.5`	Hemorrhage of anus and rectum	Significant lower GI bleeding from colon pathology may lead to operative resection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterectomy, resection of small intestine with primary anastomosis	Performed when concurrent small bowel resection is required with colectomy.
`44160`	Colectomy, partial; with colostomy or ileostomy (separate procedures)	Performed when diversion is required instead of primary anastomosis.
`44204`	Laparoscopy, surgical; colectomy, partial, with anastomosis	Minimally invasive alternative to open `44140` when laparoscopic approach is used.
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s)	May be performed preceding definitive colectomy in uncertain intra-abdominal pathology.
`44320`	Colostomy, temporary or permanent; creation	Bowel diversion code used when an ostomy is created instead of immediate anastomosis.
`44145`	Colectomy, partial; total proctocolectomy with ileo-anal anastomosis (when applicable)	Related for more extensive resections that may follow oncologic or inflammatory disease planning.