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See a sample rate comparisonCPT 44100 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Biops Of Intest By Capsule Tube Peroral (1 Or More Specimens), Biopsy Of Intestine By Capsule Tube Peroral (1 Or More Specimens)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | 51 - Multiple procedures 59 - Distinct Procedural Service 58 - Staged or related procedure during postoperative period AS - PA/NP/CNS assistant at surgery 57 - Decision for surgery AI - Principal Physician of Record |
| Complexity Level | Low |
| Medicare Fee Schedule | $91.52 national non-facility rate (2026) · View Medicare rates for 44100 |
| Medicaid Fee Schedule | $78.34 median of the 8 states in the free preview · View Medicaid rates for 44100 |
National average reimbursement for CPT 44100 by major payers:
$153.97
$148.86
$148.59
$178.24
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CPT 44100
5 of 25 sample ratesHigher to lower in this preview
White Fence Surgical Suites, LLC
White Fence Surgical Suites LLC
$2,668.00Published ratePiedmont Asc LLC
$1,258.00Published rateTriangle Orthopaedics Surgery Center
$1,000.00Published rateSurgery Center At St. Vincent, LLC, East Pavilion Surgery Center
Surgery Center At St Vincent LLC
$580.00Published rateEye Surgicenter LLC
$311.00Published rate
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See a sample payer proposalCPT 44100 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44100 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 44100 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 44100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44100 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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