2025 CPT code 44604

Suturing of the large intestine to repair a perforation, ulcer, wound, injury, or rupture, without colostomy.

Follow current CPT coding guidelines for surgical procedures.Be aware of potential unbundling issues if other procedures are performed at the same time.Code appropriately based on the extent of the procedure and any additional services rendered.

Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual and payer-specific guidelines for modifier application rules.

Medical necessity is established by the presence of a perforation, ulcer, wound, injury, or rupture of the large intestine requiring surgical repair.Documentation must support the need for surgical intervention.

The surgeon is responsible for all aspects of the procedure, from prepping the patient and making the incision to repairing the intestinal perforation, washing out the abdomen, and closing the incision.

IMPORTANT Code 44605 is used if a colostomy is created during the procedure.

In simple words: The doctor repairs a tear or hole in the large intestine using stitches and washes out the abdomen with a special solution to prevent infection.

This procedure involves suturing (colorrhaphy) the large intestine to repair a single or multiple perforations, ulcers, wounds, injuries, or ruptures.The procedure is performed without creating a colostomy.The surgeon will make an incision, repair the damaged area of the large intestine in layers using sutures, lavage (wash) the abdominal cavity with an antibiotic solution or saline to remove any spillage or bleeding, and then close the incision.

Example 1: A patient presents with symptoms of a perforated diverticulum in the sigmoid colon.The surgeon performs a laparotomy, repairs the perforation with sutures, and lavages the abdominal cavity., A patient sustains a traumatic injury to the abdomen resulting in a large intestine laceration.The surgeon performs an exploratory laparotomy, repairs the laceration using sutures, and lavages the abdomen., A patient is diagnosed with a perforated colonic ulcer. The surgeon performs a laparoscopic procedure to repair the perforation with sutures and lavages the abdomen.

Complete surgical notes including the type and location of the perforation, the method of repair, the type and amount of lavage solution used, and the condition of the abdomen after the procedure are required.Preoperative and postoperative diagnoses, and any complications encountered must also be documented.

** This code describes the repair of a perforation or injury to the large intestine without the creation of a colostomy. If a colostomy is necessary, use code 44605.

  • Revenue Code: P1G (Major Procedure - Other)
  • RVU: Data not available.Consult the current year's Medicare Physician Fee Schedule for RVU values.
  • Global Days : Data not available. The global period will depend on payer-specific guidelines.
  • Payment Status: Active
  • Modifier TC rule: The TC modifier is not applicable to this code.
  • Fee Schedule : Data not available. Consult historical Medicare Physician Fee Schedules for fee data.
  • Specialties:General Surgery, Colorectal Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.