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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 | 78 - Return to OR - related procedure 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | $1,097.55 national non-facility rate (2026) · View Medicare rates for 44125 |
| Medicaid Fee Schedule | $860.48 median of the 8 states in the free preview · View Medicaid rates for 44125 |
National average reimbursement for CPT 44125 by major payers:

$1,396.25

$1,566.75

$1,673.10

$1,872.64
Choose a payer to see a sample of rates for CPT 44125.
Burlington County Endoscopy Center LLC
Barkley Surgicenter, LLC
Barkley Surgicenter LLC
Bethesda Chevy Chase Surgery Center, LLC
Bethesda Chevy Chase Surgery Cen
Zeo Surgical Center LLC, Lenza Surgical Center
Zeo Surgical Center LLC
Asc Development Company 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 44125 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44125 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 44125 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 |
|---|---|---|
| 44120-CPT | High | Surgery On Intestines, Surgery To Remove A Section Of The Intestines. The Procedure Attaches The Resulting Open Ends Together And May Include Additional Reconstruction Of The Structures. |
| 44121-CPT | Moderate | Surgery On Intestines, Surgery To Remove A Section Of The Intestines. The Procedure Attaches The Resulting Open Ends Together And May Include Additional Reconstruction Of The Structures. |
| 44125-CPT | High | Surgery On Intestines, Surgery To Remove A Section Of The Intestines. The Procedure Attaches The Resulting Open Ends Together And May Include Additional Reconstruction Of The Structures. |
| 44126-CPT | High | Surgery On Intestines, Surgery To Remove A Section Of The Intestines. The Procedure Attaches The Resulting Open Ends Together And May Include Additional Reconstruction Of The Structures. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44125 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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