CPT 44126 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 80 - Assistant surgeon • GC - Service performed by resident under supervision |
| Complexity Level | High |
| CMS | $2,401.73 Physician Fee Schedule |
National average reimbursement for CPT 44126 by major payers:
$3,144.43
$3,264.74
$3,444.22
$3,981.86
| 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 44126 | ||||||
United | 44126 | $400.00 | 1043411648 - COFFEE COUNTY CENTER FOR DIGESTIVE DISEASES LLC | 562402712 - (GA) COFFEE COUNTY CENTER FOR DIGESTIVE DISEASES LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $2901.48 | 1447221486 - ORTHOPAEDIC OUTPATIENT SURGERY CENTER, LLC | 421508092 - (IA) ORTHOPAEDIC OUTPATIENT SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $494.00 | 1770796757 - LAPEER COUNTY SURGERY CENTER LLC | 202918877 - (MI) LAPEER COUNTY SURGERY CENTER L | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $667.00 | 1902447386 - SEATTLE PAIN RELIEF PLLC, FEDERAL WAY AMBULATORY SURGICAL FACILITY | 455527273 - (WA) SEATTLE PAIN RELIEF PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $500.00 | 1417142084 - MID- AMERICA SURGERY CENTER, LLC | 204494200 - (MO) MID AMERICA SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $449.00 | 1205266632 - ARKANSAS RENAL GROUP PA, OUACHITA PROCEDURE CENTER | 453592104 - (AR) ARKANSAS RENAL GROUP PA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $1352.00 | 1326761792 - SOUTHWEST SURGICAL CENTER LLC | 412013700 - (MN) SOUTHWEST SURGICAL CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $825.00 | 1821276353 - PEND OREILLE SURGERY CENTER LLC | 300430739 - (ID) PEND OREILLE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $700.00 | 1649250218 - LORAIN SURGERY CENTER, LLC | 201641777 - (OH) LORAIN SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $518.00 | 1952535502 - PLATEAU SURGERY CENTER | 264769256 - (TN) PLATEAU SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $988.00 | 1942267893 - GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, PA | 223345724 - (NJ) GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $589.00 | 1174571970 - DCR SURGERY CENTER, LLC | 200019313 - (OH) DCR SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $405.00 | 1588644520 - WESTGLEN ENDOSCOPY CENTER LLC, WESTGLEN ENDOSCOPY CENTER | 621707329 - WESTGLEN ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $175.00 | 1144842394 - NATIONAL CARDIOVASCULAR SURGERY CENTER, LLC, PEAK SURGERY CENTER OF AVONDALE | 843454423 - (AZ) NATIONAL CARDIOVASCULAR SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44126 | $210.00 | 1790167740 - TIDALHEALTH SURGERY CENTER, LLC | 474184623 | MD | 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 44126 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44126 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 44126 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 | Resect Sm Bowel W Anastomosis |
| 44121-CPT | Moderate | Enterectomy, Resection Of Small Intestine; Each Additional Resection And Anastomosis (List Separately In Addition To Code For Primary Procedure) |
| 44126-CPT | High | Enterectomy, Resection Of Small Intestine For Congenital Atresia, Single Resection And Anastomosis Of Proximal Segment Of Intestine; Without Tapering |
| 44127-CPT | High | Enterectomy, Resection Of Small Intestine For Congenital Atresia, Single Resection And Anastomosis Of Proximal Segment Of Intestine; With Tapering |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44126. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44126 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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