Key CPT Codes
| CPT | Descriptor | wRVU | Medicare estimate | Global |
|---|---|---|---|---|
| 49000 | Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) | 12.23 | $728.81 | 90 |
| 49002 | Reopening of recent laparotomy | 17.19 | $974.30 | 90 |
| 49014 | Reexploration pelvic wound | 6.56 | $346.03 | 0 |
| 44120 | Enterectomy, resection of small intestine; single resection and anastomosis | 20.3 | $1,136.30 | 90 |
| 44140 | Colectomy, partial; with anastomosis | 22.03 | $1,250.20 | 90 |
| 44602 | Suture small intestine | 24.1 | $1,290.28 | 90 |
| 44603 | Suture small intestine | 27.46 | $1,484.34 | 90 |
| 44604 | CPT 44604 | 17.71 | $974.64 | 90 |
| 44605 | Repair of bowel lesion | 21.53 | $1,217.80 | 90 |
| 47350 | Management of liver hemorrhage; simple repair of liver wound or injury | 21.93 | $1,285.60 | 90 |
| 32151 | Remove lung foreign body | 16.52 | $968.63 | 90 |
| 32551 | Tube thoracostomy, includes connection to drainage system | 2.96 | $142.96 | 0 |
Coding Decision Points
- Damage control cases are often staged; modifier 58/78 logic depends on the plan and global period context.
- Temporary closure, packing, bowel discontinuity, and planned return need explicit documentation.
- Unusual time, contamination, adhesions, hemorrhage, or physiologic instability may support modifier 22 only when documented in detail.
Common Documentation Gaps
State damage-control intent, physiologic instability, abbreviated operation, packing, vascular/bowel control, temporary closure, reoperation plan, and objective difficulty.
FAQ
Is damage control laparotomy a single CPT code?
No. Code the actual operative work: exploration, bowel repair/resection, hemorrhage control, drainage, temporary closure, and staged return logic.
Which modifier often matters?
Modifier 58 or 78 may matter for staged or unplanned returns; modifier 22 may apply only with strong documentation.