CPT 44202 Laparoscopic Small Bowel Resection Reimbursement | OpenPayer

Summary & Overview

CPT 44202: Laparoscopic Small Bowel Resection with Single Anastomosis

CPT code 44202 denotes a laparoscopic small bowel resection with a single resection and anastomosis. This surgical code captures minimally invasive removal of a segment of the small intestine followed by reconnection of the bowel, a procedure used for indications such as obstruction, ischemia, Crohn disease complications, or focal neoplasm. Nationally, accurate coding of this operative technique affects procedure-level utilization metrics, payer coverage determinations, and facility billing for operating room and post-operative care.

Key payers commonly involved in coverage and reimbursement for this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and discussion of how this code is applied for laparoscopic small bowel resections. The publication also presents benchmarks and comparative perspectives on utilization and payment policy where available, and highlights policy updates and documentation elements that affect billing and claims adjudication.

The content is intended to help coding professionals, surgical teams, and revenue managers understand when CPT code 44202 applies, what services it represents, and what to expect from major national payers in terms of coverage frameworks and billing considerations.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44202laparoscopic small bowel resectiongeneral surgeryanastomosisoperative codingsurgical proceduresambulatory surgeryinpatient surgery

Billing Code Overview

CPT code 44202 describes a laparoscopic resection of a portion of the small intestine with a single resection and anastomosis. The procedure involves removal of part of the small bowel and surgical reconnection of the intestinal ends using minimally invasive, laparoscopic techniques.

Service Type: Surgical — Laparoscopic small bowel resection with single anastomosis

Typical Site of Service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical setting depending on clinical factors and patient status)

Clinical & Coding Specifications

Clinical Context

A typical patient is a 58-year-old male presenting with progressive crampy abdominal pain, nausea, and intermittent small-bowel obstruction symptoms secondary to a segmental ileal stricture from chronic Crohn disease. Conservative management failed and imaging (CT enterography) demonstrated a single short-segment small bowel stricture with prestenotic dilation. The patient is scheduled for a laparoscopic small bowel resection with primary anastomosis. Preoperative workflow includes history and physical, informed consent, bowel preparation as indicated, anesthesia assessment, and perioperative antibiotic prophylaxis. Intraoperative steps include laparoscopic access, adhesiolysis as needed, identification of the diseased bowel segment, resection of the affected segment, and intracorporeal or extracorporeal single anastomosis. Postoperative workflow includes recovery in PACU, pain control, early ambulation, diet advancement as tolerated, wound and drain checks, and discharge planning with follow-up for pathology results and postoperative complications monitoring.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (standard reporting)	Use for a routine claim without special circumstance.
`22`

CPT 44210: Laparoscopic Total Colectomy with Ileoproctostomy or Ileostomy

CPT-44207-LAPAROSCOPIC-PARTIAL-COLECTOMY-COLORECTAL-ANASTOMOSIS

CPT 44207: Laparoscopic Partial Colectomy with Colorectal Anastomosis

CPT-44206-LAPAROSCOPIC-PARTIAL-COLECTOMY-END-COLOSTOMY

CPT 44206: Laparoscopic Partial Colectomy with End Colostomy

CPT-44213-LAPAROSCOPIC-SPLENIC-FLEXURE-MOBILIZATION-ADD-ON

CPT 44213: Laparoscopic Mobilization of Splenic Flexure (Add-on)

CPT-44211-LAPAROSCOPIC-TOTAL-COLECTOMY-ILEOANAL-POUCH-LOOP-ILEOSTOMY

CPT 44211: Laparoscopic Total Colectomy with Ileal Pouch and Loop Ileostomy

CPT-44203-LAPAROSCOPIC-ADDITIONAL-SMALL-INTESTINE-RESECTION-ANASTOMOSIS

CPT 44203: Additional Laparoscopic Small Intestine Resection and Anastomosis

CPT-44208-LAPAROSCOPIC-PARTIAL-COLECTOMY-COLOPROCTOSTOMY-COLOSTOMY

CPT 44208: Laparoscopic Partial Colectomy with Coloproctostomy and Colostomy

CPT-44204-LAPAROSCOPIC-PARTIAL-COLECTOMY-PRIMARY-ANASTOMOSIS

CPT 44204: Laparoscopic Partial Colectomy with Primary Anastomosis

CPT-44212-LAPAROSCOPIC-TOTAL-COLECTOMY-PROCTECTOMY-ILEOSTOMY

CPT 44212: Laparoscopic Total Colectomy with Proctectomy and Ileostomy

CPT-44205-LAPAROSCOPIC-PARTIAL-COLECTOMY-ILEOCOLIC-RESECTION-ANASTOMOSIS

CPT 44205: Laparoscopic Partial Colectomy with Ileocolic Resection

Taxonomy Code	Specialty	Notes
207L00000X	General Surgery	Most common specialty performing laparoscopic small bowel resections.
207P00000X	Colon and Rectal Surgery	Frequently performs resections for inflammatory bowel disease and benign/malignant colonic/terminal ileal disease.
208000000X	Gastroenterology (procedural overlap)	Involvement primarily for preoperative evaluation and endoscopic assessment; not the primary surgeon but part of care team.
207R00000X	Pediatric Surgery	Performs resections when this procedure is done in pediatric patients.
2086S0124X	Acute Care Surgery/Critical Care Surgery	Manages urgent/emergent small bowel resections for obstruction, ischemia, or perforation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K50.112`	Crohn disease of small intestine with intestinal obstruction	Common indication for segmental small bowel resection with anastomosis.
`K56.69`	Other intestinal obstruction	Represents small-bowel obstruction requiring surgical resection if nonoperative management fails.
`K55.0`	Acute vascular disorders of intestine (mesenteric ischemia)	Ischemic segments may require resection and primary anastomosis.
`K57.20`	Diverticulitis of small intestine with perforation and abscess	Complicated diverticular disease of jejunum/ileum requiring resection.
`K63.8`	Other specified diseases of intestine (e.g., localized benign tumors)	Localized benign neoplasms or strictures may require segmental resection.
`C17.9`	Malignant neoplasm of small intestine, unspecified	Malignancy of small bowel may be treated with segmental resection and anastomosis.
`A04.7`	Enterocolitis due to Clostridioides difficile	Severe localized disease with necrosis or perforation may mandate resection.
`K65.0`	Peritonitis (acute)	Secondary peritonitis from perforated small bowel often leads to resection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49650`	Laparoscopy, surgical; drainage of intraperitoneal abscess (e.g., post-op abscess)	May be performed if postoperative intra-abdominal abscess develops after resection.
`44120`	Enterectomy, resection of small intestine; single resection and anastomosis (open)	Open equivalent to `44202`; used when conversion from laparoscopic to open approach occurs.
`44204`	Laparoscopy, surgical; resection, small intestine, multiple resections, with anastomosis	Used when more than a single segmental resection/anastomosis is performed during the same operation.
`44970`	Repair, incarcerated or strangulated hernia; complicated (including bowel resection if performed)	May be performed concurrently when small-bowel resection is required for hernia-related ischemia.
`49440`	Removal of peritoneal drain (e.g., for postoperative drainage)	Performed when peritoneal drains placed at time of resection are removed in a separate encounter.

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