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    v1.0.31
    OpenPayerBilling CodesExcision Procedures on the Intestines (Except Rectum)CPT cpt-44147-colon-resection-open-abdominal-and-anal-approach
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    CPT 44147: Combined Abdominal and Anal Colon Resection with Anastomosis

    Medicare pays $1773 on average nationally for this procedure.

    CPT code 44147 describes an open combined abdominal and anal approach to resect an affected segment of the colon with primary reconnection (anastomosis); this is a surgical colon resection procedure typically classified as an open colorectal resection and is performed in an inpatient or hospital operating room setting for conditions requiring removal of diseased colon and restoration of bowel continuity.

    For related coverage guidance, see recent payer policy updates: Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical Policy, Esophageal Brush Biopsy, Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 55–75-year-old adult presenting with symptomatic left-sided colonic disease such as obstructive diverticulitis with stricture, recurrent segmental ischemia, or localized neoplasm not amenable to limited colectomy. The patient has progressive abdominal pain, change in bowel habits, and imaging (CT abdomen/pelvis) demonstrating a diseased segment of colon requiring resection. Preoperative evaluation includes history and physical, colonoscopy or CT colonography as indicated, labs, anesthesiology assessment, and informed consent for an open abdominal and transanal approach. In the operating room under general anesthesia, the surgical team makes an abdominal incision to mobilize the colon, performs proximal and distal mobilization through combined abdominal and anal exposures, resects the affected segment, and performs a primary anastomosis connecting the cut ends of colon. Postoperative workflow includes pain control, early ambulation, bowel function monitoring, wound care, and discharge planning with follow-up for wound check and assessment of bowel continuity and function.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    44140Colectomy, partial; with anastomosis, for example, resection of sigmoid colon with colorectal anastomosisCommon alternative for segmental open colectomy without combined transanal approach; may be performed when transanal access not required.
    44204Laparoscopy, surgical, colectomy, partial; with anastomosisMinimally invasive alternative to 44147; used when laparoscopic approach is feasible.
    44145Colectomy, partial; with end colostomy and closure of distal segment (Hartmann procedure)Performed when primary anastomosis is not feasible and diversion is required instead of immediate reconnection.
    44160Colectomy, total, proctocolectomy or colectomy with ileostomy or ileoproctostomyUsed for more extensive disease requiring total colectomy rather than segmental resection.
    44227Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomyRelated when extended resection includes terminal ileum and a different anastomosis configuration is required.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    207P00000X
    208600000X
    208D00000X
    207L00000X
    246RH0600X
    207RC0001X
    2085R0001X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    A09Infectious gastroenteritis and colitis, unspecified
    C18.4Malignant neoplasm of transverse colon
    C18.9Malignant neoplasm of colon, unspecified
    C19Malignant neoplasm of rectosigmoid junction
    C20Malignant neoplasm of rectum
    D12.6Benign neoplasm of colon, unspecified
    I82.401Acute embolism and thrombosis of unspecified deep veins of right lower extremity
    K35.80Unspecified acute appendicitis
    K50.90Crohn's disease, unspecified, without complications
    K51.90Ulcerative colitis, unspecified, without complications

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 4

    10 rows

    PolicyPayerEffective Date
    Achalasia and Gastroesophageal Reflux Disease (GERD) - Minimally Invasive Procedures - Medical PolicyHealth-New-England2027-02-01
    Esophageal Brush Biopsycaresourcegeorgia2026-12-01
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Gastric Pacing/Gastric Electrical Stimulation (GES)Cigna2026-11-15
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Percutaneous electrical nerve field stimulation for disorders of gut-brain interactionpremerabluecrossofwashington2026-11-06
    Percutaneous Electrical Nerve Field Stimulation for Disorders of Gut-Brain Interactionpremerabluecrossofwashington2026-11-06
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Non-invasive Testing for Liver FibrosisModa Health2026-11-01
    Surgical Site of Care - Colonoscopy and Sigmoidoscopyregence2026-11-01

    Related Codes

    CPT-44100-SMALL-INTESTINE-CAPSULE-BIOPSY

    CPT 44100: Small Intestine Biopsy via Oral Capsule

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

    CPT 44110: Excision of Lesion(s) From Small or Large Intestine

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

    CPT 44111: Excision of Intestinal Lesions via Multiple Incisions

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

    CPT 44120: Small Bowel Resection with Primary Anastomosis

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

    CPT 44121: Additional Small Intestine Resection and Anastomosis

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

    CPT 44125: Small Bowel Resection with Enterostomy

    CPT-44126-SMALL-BOWEL-RESECTION-CONGENITAL-ATRESIA-END-TO-END-ANASTOMOSIS

    CPT 44126: Small Bowel Resection for Intestinal Atresia with Anastomosis

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

    CPT 44127: Resection and Anastomosis for Congenital Small-Bowel Atresia

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

    CPT 44128: Resection of Small Intestine for Congenital Atresia

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

    CPT 44130: Intestinal Anastomosis, With or Without Stoma

    Showing 1–10 of 29

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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