CPT 44206 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 • AS - PA/NP/CNS assistant at surgery • 22 - Increased Procedural Services |
| Complexity Level | High |
| CMS | $1,681.70 Physician Fee Schedule |
National average reimbursement for CPT 44206 by major payers:
$2,163.43
$2,330.54
$2,485.76
$2,844.81
| 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 44206 | ||||||
United | 44206 | $307.00 | 1669424339 - ARKANSAS GASTROENTEROLOGY ENDOSCOPY CENTER | 300314945 - (AR) ARKANSAS GASTROENTEROLOGY ENDOSCOPY CENTER | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $335.00 | 1710091517 - HERSHEY OUTPATIENT SURGERY CENTER LP, HERSHEY OUTPATIENT SURGERY CENTER | 200469951 - (PA) HERSHEY OUTPATIENT SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $104.00 | 1073845087 - EYE SURGERY CENTERS OF ARIZONA, LLC, EYE SURGERY AT THE BILTMORE, LLC | 271798256 - (AZ) EYE SURGERY CENTERS OF ARIZONA 401(K) PROFIT SHARING PLAN & TRUST | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $874.00 | 1326557653 - SJ EAST CAMPUS ASC, LLC, DENVER SURGERY CENTER | 821485491 - (CO) SJ EAST CAMPUS ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $326.00 | 1154787117 - THE PENNSYLVANIA SURGERY AND LASER CENTER LLC | 300826026 - (PA) PENNSYLVANIA SURGERY AND LASER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1064.00 | 1871594275 - DESTIN SURGERY CENTER LLC | 593723179 - (FL) DESTIN SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $582.00 | 1093053381 - NORTH COUNTRY EC LLC, NORTHEASTERN NEW YORK SURGICAL CENTER | 453715451 - (NY) NORTH COUNTRY EC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1049.00 | 1346237328 - VICTORIA AMBULATORY SURGERY CENTER, LP, THE SURGERY CENTER | 352240144 - (TX) VICTORIA AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $442.00 | 1346416690 - GARDEN STATE AMBULATORY SURGERY CENTER PC | 223504597 - (NJ) GARDEN STATE AMBULATORY SURGERY CENTER PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $550.00 | 1588224802 - FLOWOOD SURGERY CENTER LLC | 842131306 - (MS) FLOWOOD SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $782.00 | 1497834931 - VISION CARE CENTER, A MEDICAL GROUP INC, EYE-Q SURGERY CENTER | 941717441 - VISION CARE CENTER, A MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $708.00 | 1619013455 - RUSH SURGICENTER AT THE PROFESSIONAL BUILDING LTD. PARTNERSHIP, RUSH SURGICENTER LTD. PARTNERSHIP | 363853026 - (IL) RUSH SURGICENTER, LTD. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1049.00 | 1104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER | 205537270 - (TX) NORTHWEST SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $312.00 | 1902832405 - COASTAL SURGERY CENTER, LLC | 202667835 - (FL) COASTAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1420.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | 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 44206 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44206 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 44206 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 |
|---|---|---|
| 44145-CPT | High | Colectomy Partial W Coloproctostomy |
| 44204-CPT | High | Laparoscopy, Surgical; Colectomy, Partial, With Anastomosis |
| 44205-CPT | High | Laparoscopy, Surgical; Colectomy, Partial, With Removal Of Terminal Ileum With Ileocolostomy |
| 44206-CPT | High | Laparoscopy, Surgical; Colectomy, Partial, With End Colostomy And Closure Of Distal Segment (Hartmann Type Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44206. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44206 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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