Find policies, billing codes, payers, states, and providers

CPT 44700: Small Bowel Barrier Placement to Protect Pelvis

CPT code 44700 identifies a surgical procedure to place a physical barrier between the small intestine and the pelvis to protect the bowel from radiation damage. Clinically, this procedure matters nationally as an intervention to reduce acute and chronic radiation enteritis for patients undergoing pelvic radiation for malignancies or other pelvic conditions. It is relevant to surgical, radiation oncology, and gastrointestinal care teams.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context, common settings where the service is delivered, and the payer landscape relevant to coverage and billing practices. The publication outlines benchmark considerations, typical modifier usage patterns (listed separately), and how the procedure is documented for claims.

This summary provides readers with the clinical purpose of the code, the typical sites of service, and what to expect in payer discussions and claims workflows. Data not available in the input is noted where applicable in detailed sections.

Customize your policy alerts

Sign up for cpt 44700 policy alerts

Get alerted when payer policies referencing 44700 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 44700 describes a surgical procedure in which the provider places a barrier between the small intestine and the pelvis to protect the bowel from damage during pelvic radiation therapy. This service is typically performed as a surgical intervention to reduce radiation enteritis risk by physically separating mobile small bowel from the radiation field.

Service type: Surgical placement of pelvic-small bowel barrier
Typical site of service: Operating room or ambulatory surgical center, performed by a surgeon with appropriate training in abdominal or pelvic procedures

Find policies, billing codes, payers, states, and providers

CPT 44700: Small Bowel Barrier Placement to Protect Pelvis

Customize your policy alerts

Sign up for cpt 44700 policy alerts

Get alerted when payer policies referencing 44700 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Surgical placement of pelvic-small bowel barrier
Typical site of service: Operating room or ambulatory surgical center, performed by a surgeon with appropriate training in abdominal or pelvic procedures

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult undergoing pelvic external-beam radiation for gynecologic or rectal malignancy (for example, postoperative cervical cancer or recurrent rectal cancer) where prior abdominal surgery or planned radiation port placement risks exposing loops of small intestine to high-dose radiation. The multidisciplinary workflow begins with consultation between radiation oncology and surgical teams. The surgeon evaluates the patient preoperatively, reviews imaging to localize small-bowel loops relative to the pelvis, and plans a minimally invasive or open operative approach. In the operating room under general anesthesia, the surgeon creates and places a physical barrier (peritoneal spacer, omental flap, or synthetic absorbable mesh) between the small intestine and pelvic radiation field to reduce bowel dose and subsequent radiation enteritis. Postoperative care includes routine surgical monitoring, pain control, bowel function assessment, and coordination with radiation oncology to resume or begin planned radiation therapy once the surgical site has sufficiently healed.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work required to place the spacer is substantially greater than usual due to complexity, extensive adhesiolysis, or unexpected findings.
`23`	Unusual anesthesia	Use when general anesthesia is administered but the procedure is usually performed with local or no anesthesia; rarely applicable but available if anesthesia circumstances are atypical.
`26`	Professional component	Use when reporting only the professional component of a separately payable service related to imaging or intraoperative consultation; limited applicability.
`50`	Bilateral procedure	Use if anatomic bilateral placement is reported and payer requires bilateral modifier for bilateral work (rare for this code).
`51`	Multiple procedures	Use when `44700` is reported in addition to other distinct surgical procedures performed during the same operative session.
`52`	Reduced services	Use if the procedure was partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after anesthesia is administered.
`58`	Staged or related procedure by same physician during postoperative period	Use when `44700` is planned as a staged procedure after an earlier operation.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons during the same operative session.
`76`	Repeat procedure by same physician	Use when the same physician performs a repeat procedure later the same day (note: `76` is not listed in input modifiers; use only modifiers provided).
`63`	Procedure performed on infants less than 4 kg	Use rarely if procedure performed on a qualifying neonate or infant variant (if clinically applicable).
`66`	Surgical team (moderate to complex cases)	Use when a surgical team approach is reported for complex cases requiring multiple surgeons.
`78`	Return to the operating room for a related procedure during the global period	Use if a return to OR is required for a related complication during the global period.
`80`	Assistant surgeon	Use when a qualified assistant surgeon (general surgical assistant) actively assists during the procedure.

Taxonomy Code	Specialty	Notes
2080S0105X	General Surgery	General surgeons frequently perform adhesiolysis and spacer placement, open or laparoscopic.
2080P0206X	Surgical Oncology	Surgical oncologists perform spacer placement in oncologic pelvic procedures.
207L00000X	Gynecologic Oncology	Gynecologic oncologists place spacers for pelvic radiation protection in cervical, endometrial, or vaginal cancers.
223Q00000X	Radiation Oncology	Radiation oncologists coordinate indications and timing, though they do not typically perform the surgical procedure.
207K00000X	Colon and Rectal Surgery	Colorectal surgeons place spacers when treating rectal or pelvic malignancies and preparing for radiation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Cervical cancer commonly requires pelvic radiation; spacer placement protects small bowel from pelvic radiation fields.
`C20`	Malignant neoplasm of rectum	Rectal cancer treated with pelvic radiotherapy may require bowel displacement to reduce enteric toxicity.
`C54.9`	Malignant neoplasm of corpus uteri, unspecified	Endometrial cancers requiring adjuvant pelvic radiation may prompt spacer placement in selected cases.
`C79.2`	Secondary malignant neoplasm of liver	Metastatic pelvic disease with planned pelvic radiation may necessitate small-bowel protection if radiation fields extend inferiorly.
`Z92.3`	Personal history of irradiation	History of prior irradiation increases risk of cumulative bowel toxicity and supports use of spacer for re-irradiation planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterolysis (separate procedure)	May be performed before or during spacer placement when extensive adhesions tether small bowel to the pelvis and require lysis to allow safe mobilization of bowel away from the radiation field.
`49560`	Repair of initial incisional or ventral hernia with graft or mesh	Performed in patients with prior abdominal wall defects where mesh placement or revision is required in the same operative session.
`58661`	Laparoscopy, surgical; with removal of adnexal structures (partial or total)	Common concurrent procedure in gynecologic oncology cases where adnexal surgery and spacer placement occur together.
`19318`	Implantation of spacer (pelvic) — note: CPT does not have a specific pelvic spacer code beyond `44700`	Use as contextual reference; `44700` is the code describing placement of a barrier between small intestine and pelvis for radiation protection.
`49200`	Repair of parastomal hernia	May be performed in complex pelvic operations when stoma-related issues are addressed during the same hospitalization.

CPT 44701: Colon Irrigation During Colectomy or Large Intestine Repair

CPT-44705-DONOR-STOOL-SCREENING-AND-PREPARATION-FOR-INSTILLATION

CPT 44705: Donor Stool Screening and Preparation for Instillation

CPT-44715-INTESTINAL-GRAFT-PREPARATION-SUPERIOR-MESENTERIC-VESSELS

CPT 44715: Small Intestine Graft Preparation for Transplantation

CPT-44720-SMALL-INTESTINE-PREPARATION-FOR-ANASTOMOSIS

CPT 44720: Small Intestine Preparation for Anastomosis

CPT-44721-SMALL-INTESTINE-PREPARATION-ARTERY-ANASTOMOSIS

CPT 44721: Preparation of Harvested Small Intestine for Arterial Anastomosis

CPT-44799-UNLISTED-INTESTINAL-PROCEDURE

CPT 44799: Unlisted Intestinal Procedure

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work required to place the spacer is substantially greater than usual due to complexity, extensive adhesiolysis, or unexpected findings.
`23`	Unusual anesthesia	Use when general anesthesia is administered but the procedure is usually performed with local or no anesthesia; rarely applicable but available if anesthesia circumstances are atypical.
`26`	Professional component	Use when reporting only the professional component of a separately payable service related to imaging or intraoperative consultation; limited applicability.
`50`	Bilateral procedure	Use if anatomic bilateral placement is reported and payer requires bilateral modifier for bilateral work (rare for this code).
`51`	Multiple procedures	Use when `44700` is reported in addition to other distinct surgical procedures performed during the same operative session.
`52`	Reduced services	Use if the procedure was partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances after anesthesia is administered.
`58`	Staged or related procedure by same physician during postoperative period	Use when `44700` is planned as a staged procedure after an earlier operation.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons during the same operative session.
`76`	Repeat procedure by same physician	Use when the same physician performs a repeat procedure later the same day (note: `76` is not listed in input modifiers; use only modifiers provided).
`63`	Procedure performed on infants less than 4 kg	Use rarely if procedure performed on a qualifying neonate or infant variant (if clinically applicable).
`66`	Surgical team (moderate to complex cases)	Use when a surgical team approach is reported for complex cases requiring multiple surgeons.
`78`	Return to the operating room for a related procedure during the global period	Use if a return to OR is required for a related complication during the global period.
`80`	Assistant surgeon	Use when a qualified assistant surgeon (general surgical assistant) actively assists during the procedure.

Taxonomy Code	Specialty	Notes
2080S0105X	General Surgery	General surgeons frequently perform adhesiolysis and spacer placement, open or laparoscopic.
2080P0206X	Surgical Oncology	Surgical oncologists perform spacer placement in oncologic pelvic procedures.
207L00000X	Gynecologic Oncology	Gynecologic oncologists place spacers for pelvic radiation protection in cervical, endometrial, or vaginal cancers.
223Q00000X	Radiation Oncology	Radiation oncologists coordinate indications and timing, though they do not typically perform the surgical procedure.
207K00000X	Colon and Rectal Surgery	Colorectal surgeons place spacers when treating rectal or pelvic malignancies and preparing for radiation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C53.9`	Malignant neoplasm of cervix uteri, unspecified	Cervical cancer commonly requires pelvic radiation; spacer placement protects small bowel from pelvic radiation fields.
`C20`	Malignant neoplasm of rectum	Rectal cancer treated with pelvic radiotherapy may require bowel displacement to reduce enteric toxicity.
`C54.9`	Malignant neoplasm of corpus uteri, unspecified	Endometrial cancers requiring adjuvant pelvic radiation may prompt spacer placement in selected cases.
`C79.2`	Secondary malignant neoplasm of liver	Metastatic pelvic disease with planned pelvic radiation may necessitate small-bowel protection if radiation fields extend inferiorly.
`Z92.3`	Personal history of irradiation	History of prior irradiation increases risk of cumulative bowel toxicity and supports use of spacer for re-irradiation planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44120`	Enterolysis (separate procedure)	May be performed before or during spacer placement when extensive adhesions tether small bowel to the pelvis and require lysis to allow safe mobilization of bowel away from the radiation field.
`49560`	Repair of initial incisional or ventral hernia with graft or mesh	Performed in patients with prior abdominal wall defects where mesh placement or revision is required in the same operative session.
`58661`	Laparoscopy, surgical; with removal of adnexal structures (partial or total)	Common concurrent procedure in gynecologic oncology cases where adnexal surgery and spacer placement occur together.
`19318`	Implantation of spacer (pelvic) — note: CPT does not have a specific pelvic spacer code beyond `44700`	Use as contextual reference; `44700` is the code describing placement of a barrier between small intestine and pelvis for radiation protection.
`49200`	Repair of parastomal hernia	May be performed in complex pelvic operations when stoma-related issues are addressed during the same hospitalization.

CPT 44701: Colon Irrigation During Colectomy or Large Intestine Repair

CPT-44705-DONOR-STOOL-SCREENING-AND-PREPARATION-FOR-INSTILLATION

CPT 44705: Donor Stool Screening and Preparation for Instillation

CPT-44715-INTESTINAL-GRAFT-PREPARATION-SUPERIOR-MESENTERIC-VESSELS

CPT 44715: Small Intestine Graft Preparation for Transplantation

CPT-44720-SMALL-INTESTINE-PREPARATION-FOR-ANASTOMOSIS

CPT 44720: Small Intestine Preparation for Anastomosis

CPT-44721-SMALL-INTESTINE-PREPARATION-ARTERY-ANASTOMOSIS

CPT 44721: Preparation of Harvested Small Intestine for Arterial Anastomosis

CPT-44799-UNLISTED-INTESTINAL-PROCEDURE

CPT 44799: Unlisted Intestinal Procedure

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 44700: Small Bowel Barrier Placement to Protect Pelvis

Sign up for cpt 44700 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 44700: Small Bowel Barrier Placement to Protect Pelvis

Sign up for cpt 44700 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References