2025 CPT code 44955
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Appendix Surgery Feed
Appendectomy performed for a specific reason during another major procedure.
Modifiers may apply to the primary procedure, not typically to 44955 directly, since it is an add-on code.
Medical necessity for 44955 is established by the presence of a diseased appendix discovered during another major surgical procedure. Documentation should support the non-incidental nature of the appendectomy.
The surgeon performs the appendectomy during the course of another major abdominal surgery. This includes prepping the patient, making the incision, identifying and removing the appendix, closing the incision, and then proceeding with the other planned major procedure.
In simple words: Removal of the appendix during another major surgery because it's inflamed, scarred, or at risk of rupturing.
This code describes an appendectomy performed at the time of another major surgical procedure for a specific indication, such as appendicitis (active inflammation), evidence of prior inflammation or scarring, or to prevent potential rupture during the other procedure. It is not used for incidental appendectomy of a normal appendix discovered during another surgery.It is reported in addition to the primary procedure code.
Example 1: A patient undergoing a right hemicolectomy for colon cancer also has a chronically inflamed appendix. The surgeon removes the appendix (44955) during the same procedure, along with the hemicolectomy., A patient undergoing a hysterectomy for fibroids is found to have an acutely inflamed appendix.The surgeon performs an appendectomy (44955) along with the hysterectomy., During a c-section, the obstetrician notices significant adhesions around the appendix raising concern for possible future complications.An appendectomy (44955) is performed at the same time as the c-section.
Documentation should support the medical necessity of the appendectomy (e.g., inflammation, scarring). The operative report should clearly describe the appendectomy procedure, including the findings related to the appendix, and its relationship to the primary surgical procedure.
** Always check payer-specific guidelines for reimbursement policies related to add-on codes. Accurate and detailed documentation is essential for proper coding and reimbursement.
- Global Days : Global days are determined by the primary procedure.
- Payment Status: Active
- Modifier TC rule: No TC modifier applies directly to the add-on code 44955.
- Specialties:General Surgery,Obstetrics/Gynecology, other surgical specialties depending upon the primary procedure.
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center