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See a sample rate comparisonCPT 44204 Fee Schedule
Last Verified: October 2026
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.
Scope Surgery To Remove Colon, Surgery Aided By A Scope (Laparoscope) To Remove A Section Of The Large Intestine (Colon). The Procedure Involves Reattaching The Resulting Open Ends Of The Intestine.
| 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 | AS - PA/NP/CNS assistant at surgery 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $1,413.19 national non-facility rate (2026) · View Medicare rates for 44204 |
| Medicaid Fee Schedule | $1,112.83 median of the 8 states in the free preview · View Medicaid rates for 44204 |
National average reimbursement for CPT 44204 by major payers:
$1,940.59
$2,056.84
$2,198.44
$2,456.51
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CPT 44204
5 of 25 sample ratesHigher to lower in this preview
Surgicenter Of Kansas City, LLC
$7,121.00Published rateEc Laser And Surgery Institute Of Wi, LLC
Ec Laser And Surgery Institute Of Wi LLC
$3,506.00Published rateFlorham Park Endoscopy Asc LLC, Florham Park Endoscopy Center
Florham Park Endoscopy Center, LLC
$2,622.00Published rateSan Diego Eyecor LLC
San Diego Eye Cor., Inc.
$1,979.00Published rateColumbia Endoscopy Center, LLC
Columbia Endoscopy Center LLC
$1,014.00Published rate
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See a sample payer proposalCPT 44204 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44204 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 44204 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 |
|---|---|---|
| 44203-CPT | Moderate | Intestine Removal With Scope, Surgery Aided By A Scope (Laparoscope) To Remove A Section Of The Intestines. The Procedure Reattaches The Resulting Open Ends Of The Intestines. |
| 44204-CPT | High | Scope Surgery To Remove Colon, Surgery Aided By A Scope (Laparoscope) To Remove A Section Of The Large Intestine (Colon). The Procedure Involves Reattaching The Resulting Open Ends Of The Intestine. |
| 44205-CPT | High | Colon Removal With Scope, Surgery Aided By A Scope (Laparoscope) To Remove Part Of The Intestine (Colon). The Procedure Also Creates An Opening In The Abdomen For Draining Waste. |
| 44206-CPT | High | Colon Removal With Scope, Surgery Aided By A Scope (Laparoscope) To Remove Part Of The Intestine (Colon). The Procedure Also Creates An Opening In The Abdomen For Draining Waste. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44204. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44204 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by medical professionals to report medical, surgical, and diagnostic services. They are critical for accurate billing, processing insurance claims, and maintaining consistent healthcare records.
To find the cost of a specific medical procedure, you'll typically need the CPT code for that service and your specific location. For a reliable way to look up fee schedules and estimated costs based on CPT codes and locations, you should use Payerprice's fee schedule lookup tool. This will provide more tailored information than general sources.
The final cost of a medical service is influenced by several factors, including the specific CPT code for the procedure, your geographic location, the healthcare provider's rates, your insurance coverage details (deductibles, co-pays, out-of-pocket maximums), and whether the provider is in-network or out-of-network. For a detailed lookup of fee schedules by CPT code and location, Payerprice offers a specialized tool.
Yes, there are tools available to estimate medical procedure costs. For a comprehensive lookup of fee schedules based on CPT codes and specific locations, you should use Payerprice's fee schedule lookup tool. This tool can help you understand potential costs before a procedure.
Understanding medical procedure costs beforehand empowers you to make informed healthcare decisions, plan financially, and avoid unexpected bills. It allows you to compare prices, budget effectively, and discuss costs with your provider or insurance company. Tools like Payerprice's fee schedule lookup can assist in this process by providing location-specific cost estimates.