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See a sample rate comparisonCPT 44020 Fee Schedule
Last Verified: October 2026
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.
Intestine Exam And Surgery, Surgery To Explore The Intestines. The Procedure May Remove A Sample Of Tissue For Testing (Biopsy) Or Remove A Foreign Object.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $915.19 national non-facility rate (2026) · View Medicare rates for 44020 |
| Medicaid Fee Schedule | $715.545 median of the 8 states in the free preview · View Medicaid rates for 44020 |
National average reimbursement for CPT 44020 by major payers:
$1,197.07
$1,289.73
$1,355.89
$1,545.62
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CPT 44020
5 of 25 sample ratesHigher to lower in this preview
Kennedy Cherry Hill Surgical Center LLC, Jefferson Surgery Center - Cherry Hill
Kennedy Cherry Hill Surgical Center LLC
$2,870.00Published rateHastings Surgical Center, LLC, Hastings Surgical Center
Hastings Surgical Center LLC
$1,108.00Published rateFresenius Access Care Physicians Of Madison Asc LLC
$604.00Published rateMission Surgery Center LLC
$410.00Published rateArrowhead Endoscopy And Pain Management Center LLC, Arrowhead Endoscopy Center.
Arrowhead Endoscopy And Pain Man
$108.00Published rate
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See a sample payer proposalCPT 44020 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44020 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 44020 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, Unlisted Procedure Stomach |
| 44005-CPT | High | Enterolysis (Freeing Of Intestin Adhesion) (Sepa Proc), Enterolysis (Freeing Of Intestinal Adhesion) (Separate Procedure) |
| 44010-CPT | High | Intestine Exam And Surgery, Surgery To Explore The Intestines. The Procedure May Remove A Sample Of Tissue For Testing (Biopsy) Or Remove A Foreign Object. |
| 44020-CPT | High | Intestine Exam And Surgery, Surgery To Explore The Intestines. The Procedure May Remove A Sample Of Tissue For Testing (Biopsy) Or Remove A Foreign Object. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44020 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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