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See a sample rate comparisonHealthcare 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 22 - On Campus Outpatient Hospital |
| Common Modifiers | GC - Service performed by resident under supervision 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | $1,377.79 national non-facility rate (2026) · View Medicare rates for 44055 |
| Medicaid Fee Schedule | $1,074.92 median of the 8 states in the free preview · View Medicaid rates for 44055 |
National average reimbursement for CPT 44055 by major payers:

$1,823.18

$1,972.97

$2,122.43

$2,347.44
Choose a payer to see a sample of rates for CPT 44055.
Texas Health Orthopedic Surgery Center Alliance, LLC, Texas Health Orthopedic Surgery Center Heritage
Texas Health Orthopedic Surgery Center Alliance LLC
Florida Springs Surgery Center LLC
Florida Springs Surgery Center L
Midwest Surgery Center Inc
Metairie La Endoscopy Asc LLC, Mga Gastrointestinal Diagnostic And Therapeutic Center-Metairie
Glen Endoscopy Center, LLC
The Glen Endoscopy Center, LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 44055 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44055 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 44055 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 |
|---|---|---|
| 44025-CPT | High | Exploratory Surgery Intestine, Surgery To Explore The Large Intestine. The Procedure May Include Removal Of A Foreign Object Or Take A Sample Of Tissue For Testing (Biopsy). |
| 44050-CPT | High | Reduct Of Volvulus Intussusception Intern Hernia By Laparotomy, Reduction Of Volvulus Intussusception Internal Hernia By Laparotomy |
| 44055-CPT | High | Correction Of Malrotation By L, Correction Of Malrotation By Lysis Of Duodenal Bands Andor Reduction Of Midgut Volvulus (Eg Ladd Procedure) |
| 44100-CPT | Low | Biops Of Intest By Capsule Tube Peroral (1 Or More Specimens), Biopsy Of Intestine By Capsule Tube Peroral (1 Or More Specimens) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44055 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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