CPT 44010 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 80 - Assistant surgeon |
| Complexity Level | High |
| CMS | $822.57 Physician Fee Schedule |
National average reimbursement for CPT 44010 by major payers:
$1,042.07
$1,139.25
$1,181.57
$1,402.72
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 44010 | ||||||
United | 44010 | $425.00 | 1497368013 - PHYSICIANS REGIONAL SURGERY CENTER LLC | 842179117 - (OH) PHYSICIANS REGIONAL SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $865.00 | 1376774208 - DIGESTIVE DISEASES DIAGNOSTIC & TREATMENT CENTER LLC | 261319443 - (NY) DIGESTIVE DISEASES DIAGNOSTIC TREATMENT CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $611.00 | 1154422541 - BRUNSWICK PAIN TREATMENT CENTER, LLC | 562441571 - (GA) BRUNSWICK PAIN TREATMENT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $594.00 | 1063733095 - WOLFE SURGERY CENTER, LLC | 272625124 - (IA) WOLFE SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $413.00 | 1134677990 - CENTER FOR EYE SURGERY, LLC | 813369249 - (FL) CENTER FOR EYE SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $435.00 | 1700876703 - RIVERSIDE SURGERY CENTER INC | 593599967 - (FL) RIVERSIDE SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $620.00 | 1992999775 - SPINE SURGERY CENTER OF EUGENE, LLC | 203303351 - (OR) SPINE SURGERY CENTER OF EUGENE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $1043.00 | 1245288257 - SURGICAL CENTER OF GREENSBORO, LLC | 631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $1028.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $1028.00 | 1891148219 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $603.00 | 1437100666 - HEARTLAND CATARACT & LASER SURGERY CENTER, INC., HEARTLAND CATARACT & LASER SURGERY CENTER | 470824936 - (NE) HEARTLAND CATARACT LASER SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $585.00 | 1518280684 - NORTHWEST SURGERY CENTER, INC. | 364663721 - (CA) NORTHWEST SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $1344.00 | 1932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER | 223777533 - (NJ) MAY STREET SURGI CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $550.00 | 1376194431 - ASCENT SURGERY CENTER LLC | 823347568 - (TX) ASCENT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44010 | $7400.00 | 1477846145 - INDIANA UNIVERSITY HEALTH SAXONY SURGERY CENTER LLC, SAXONY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 44010 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44010 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 44010 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 43999-CPT | High | Unlisted Procedure, Stomach Intestines |
| 44005-CPT | High | Enterolysis W Acute Bowel Obstruct |
| 44010-CPT | High | Duodenotomy |
| 44015-CPT | Low | Tube Or Needle Catheter Jejunostomy For Enteral Alimentation, Intraoperative, Any Method (List Separately In Addition To Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44010 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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