CPT 44158 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 80 - Assistant surgeon • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| CMS | $2,174.01 Physician Fee Schedule |
National average reimbursement for CPT 44158 by major payers:
$2,814.95
$2,986.82
$3,078.11
$3,656.44
| 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 44158 | ||||||
United | 44158 | $443.00 | 1043565542 - MAGNOLIA SURGERY CENTER, LLC | 364702180 - (AR) MAGNOLIA SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $1028.00 | 1104907328 - ANDREWS INSTITUTE ASC LLC | 352274952 - (FL) ANDREWS INSTITUTE ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $769.00 | 1689679680 - TOSC, LLC, OSC-HMHP, LLC | 10724836 - (OH) THE ORTHOPAEDIC SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $819.00 | 1518373695 - HOLLYWOOD SURGICAL CENTER, LLC | 462573171 - (FL) HOLLYWOOD SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $649.00 | 1407188659 - LIMESTONE SURGERY CENTER LLC | 271490855 - (GA) LIMESTONE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $633.00 | 1447301593 - 481 ASC PROJECT LLC, EYE MD LASER & SURGERY CENTER LLC | 943272782 - (CA) 481 ASC PROJECT LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $1064.00 | 1972869881 - ADVANCED SURGERY CENTER OF BETHESDA, LLC | 454376136 - (MD) ASC BETHESDA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $400.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $517.00 | 1932321882 - DIGESTIVE HEALTH CENTER OF HUNTINGTON | 811030907 - (NY) DHCH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $171.00 | 1588777130 - J J YOUNG MD, THE CATARACT CENTER OF LAWTON | 731221077 - (OK) J J YOUNG MD | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $1030.00 | 1831551266 - INOV8 SURGICAL AT MEMORIAL CITY, INOV8 SURGICAL | 475640889 - (TX) INOV8 SURGICAL AT MEMORIAL CITY | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $557.00 | 1245233410 - SURGICAL SPECIALTY CENTER OF NORTHEASTERN PENNSYLVANIA, LLC | 233022566 - (PA) SURGICAL SPECIALTY CENTER OF N | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $430.00 | 1407954365 - ASC-TCG, LLC, TRI-COUNTY CENTER FOR ENDOSCOPY & SURGERY | 43692535 - (MI) ASC - TCG LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $6646.00 | 1649482449 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44158 | $1300.00 | 1811936933 - MOORESVILLE HOSPITAL MANAGMENT ASSOCIATES INC, SURGICAL CENTER OF LAKE NORMAN | 592612221 - (NC) MOORESVILLE HOSPITAL MANAGEMENT ASSOCIATES, LLC | NC | 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 44158 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44158 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 44158 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 |
|---|---|---|
| 44155-CPT | High | Colectomy,Total, Abd, W/Proctectomy; W/I |
| 44156-CPT | High | Removal Of Large Bowel And Rectum And Creation Of Opening From End Of Small Bowel To Skin Through Abdomen, With Creation Of Small Bowel Pouch |
| 44157-CPT | High | Colectomy, Total, Abdominal, With Proctectomy; With Ileoanal Anastomosis, Includes Loop Ileostomy, And Rectal Mucosectomy, When Performed |
| 44158-CPT | High | Colectomy, Total, Abdominal, With Proctectomy; With Ileoanal Anastomosis, Creation Of Ileal Reservoir (S Or J), Includes Loop Ileostomy, And Rectal Mucosectomy, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44158. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44158 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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