Available online 17 September 2025, 101133

Billing, coding, and reimbursement have long-been an essential function of Colorectal practice whether one is employed or in private practice. Historically, billing and coding, as well as practice management and administration, have not been prioritized as part of the curriculum of general surgical and colorectal training programs leaving many surgeons inadequately educated about appropriate and effective billing and coding practices. Lacking knowledge about billing and coding deprives surgeons of an important negotiating tool in employment contracting and threatens financial stability for surgeons, hospitals, and health systems over years of practice. Effective billing and coding that lead to maximized reimbursement has become particularly relevant as physicians and healthcare institutions are continually under greater pressure to derive more revenue from patient care to support their compensation and the overall financial stability of hospitals across the country.

This volume of Seminars in Colon & Rectal Surgery aims to educate the reader about several important facts and themes regarding effective coding, billing, and reimbursement in Colorectal practice. The reader will understand how codes are created and valued by the American Medical Association (AMA) and the Centers for Medicare and Medicaid (CMS) through the Current Procedural Terminology (CPT®) and Relative Value Update Scale Committee (RUC) processes. The reader will also have an opportunity to explore advanced coding and billing to maximize reimbursement as it applies to complex open abdominal surgery and abdominal and anorectal procedures that do not have specific billing codes and thus, are designated as unlisted codes. Finally, understanding will expand to the broader healthcare landscape with a focus on benchmarking physician productivity and compensation as well as a detailed overview of Diagnosis Related Groups (DRGs) and Hierarchical Condition Categories (HCCs) and how they are relevant to surgeons and the health care institutions where surgical care is provided.

This Guest Editor and the Authors sincerely hope that the reader will find meaningful information throughout this edition of Seminars of Colon & Rectal Surgery that can be brought forth to affect an impactful enhancement to the billing, coding, and reimbursement strategies used daily in Colorectal surgical practice.

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