CPT 44021
Global 090 ActiveDecompress small bowel
CPT 44021 Billing & Documentation Guide
CPT code 44021 (Decompress small bowel) is classified under Surgery (Digestive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 15.9, a non-facility practice expense RVU of 7.35, and a malpractice RVU of 3.96, a total non-facility RVU of 27.21 and facility RVU of 27.21. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $911.35, though rates vary from $807 to $1130.94 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 44021, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 44021 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 44021 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 44021
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 15.9 | 15.9 |
| Practice Expense RVU | 7.35 | 7.35 |
| Malpractice RVU | 3.96 | 3.96 |
| Total RVU | 27.21 | 27.21 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 44021
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $912.33 | $912.33 | $880.06 - $1014.39 | 29 |
| Florida | $1034.87 | $1034.87 | $964.57 - $1121.14 | 3 |
| Georgia | $924.34 | $924.34 | $907.72 - $940.95 | 2 |
| Illinois | $1022.91 | $1022.91 | $961.95 - $1085.07 | 4 |
| Michigan | $947.76 | $947.76 | $904.54 - $990.98 | 2 |
| North Carolina | $844.64 | $844.64 | $844.64 - $844.64 | 1 |
| New York | $1009.96 | $1009.96 | $857.28 - $1102.58 | 5 |
| Ohio | $888.54 | $888.54 | $888.54 - $888.54 | 1 |
| Pennsylvania | $917.71 | $917.71 | $881.43 - $953.99 | 2 |
| Texas | $898.55 | $898.55 | $877.35 - $961.1 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 44021
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 44021 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 44021
What does CPT code 44021 mean? +
CPT code 44021 represents: Decompress small bowel. It's in the Surgery (Digestive) category with a global period of 090.
What is the Medicare reimbursement for CPT 44021? +
The 2026 Medicare national average non-facility payment for CPT 44021 is $911.35. Rates range from $807 to $1130.94 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 44021? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 44021? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 21, 2026.
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