CPT 44955
Global ZZZ ActiveAppendectomy add-on
CPT 44955 Billing & Documentation Guide
CPT code 44955 (Appendectomy add-on) is classified under Surgery (Digestive) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.49, a non-facility practice expense RVU of 0.39, and a malpractice RVU of 0.36, a total non-facility RVU of 2.24 and facility RVU of 2.24. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $74.67, though rates vary from $65.95 to $95.15 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 44955, 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 44955 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 44955 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 44955
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.49 | 1.49 |
| Practice Expense RVU | 0.39 | 0.39 |
| Malpractice RVU | 0.36 | 0.36 |
| Total RVU | 2.24 | 2.24 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 44955
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 | $73.49 | $73.49 | $71.34 - $80.47 | 29 |
| Florida | $86.24 | $86.24 | $80.29 - $93.74 | 3 |
| Georgia | $76.66 | $76.66 | $75.72 - $77.59 | 2 |
| Illinois | $85.51 | $85.51 | $80.45 - $90.8 | 4 |
| Michigan | $78.93 | $78.93 | $75.24 - $82.61 | 2 |
| North Carolina | $69.6 | $69.6 | $69.6 - $69.6 | 1 |
| New York | $83.01 | $83.01 | $70.6 - $90.77 | 5 |
| Ohio | $73.78 | $73.78 | $73.78 - $73.78 | 1 |
| Pennsylvania | $75.83 | $75.83 | $73.09 - $78.57 | 2 |
| Texas | $74.04 | $74.04 | $72.45 - $79.65 | 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 44955
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 44955 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11006 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11042 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11043 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11044 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11045 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11046 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 44955
What does CPT code 44955 mean? +
CPT code 44955 represents: Appendectomy add-on. It's in the Surgery (Digestive) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 44955? +
The 2026 Medicare national average non-facility payment for CPT 44955 is $74.67. Rates range from $65.95 to $95.15 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 44955? +
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 44955? +
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 May 31, 2026.
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