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 |
| Medicare Fee Schedule | View Medicare rates for 44206 |
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 | $200.00 | 1184078503 - PIMA HEART ASC LLC, PIMA HEART ASC LLC | 812315336 - (AZ) PIMA HEART ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1167.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1049.00 | 1396174454 - SURGERY CENTER OF SCOTTSDALE LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $238.00 | 1023115078 - MAIN LINE PA ENDOSCOPY ASC LP, MAIN LINE ENDOSCOPY CENTER MALVERN | 205301211 | PA | 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 | $797.00 | 1174590434 - HARMONY SURGERY CENTER, LLC, HARMONY AMBULATORY SURGERY CENTER, LLC | 841479751 - (CO) HARMONY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $13865.00 | 1861444838 - LAS CRUCES SURGERY CENTER LP, MOUNTAINVIEW SURGERY CENTER | 421584742 | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $330.00 | 1376886887 - REEVES EYE SURGERY CENTER LLC | 455006590 - (TN) REEVES EYE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $573.00 | 1427690775 - CARDIAC AND VASCULAR INSTITUTE AMBULATORY SURGERY CENTER, LLC | 851809741 - (FL) CARDIAC AND VASCULAR INSTITUTE AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1306.00 | 1164513149 - ENDO-SURGI OF UNION ASC LLC | 223248249 - (NJ) ENDO-SURGI CENTER, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $687.00 | 1275708919 - WOMEN'S SURGICAL CENTER AT NORTHCARE, LLC | 261411936 - (CO) WOMEN S SURGICAL CENTER AT NOR | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $273.00 | 1710032842 - MSC AMBULATORY SURGICAL CENTER | 202155076 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $1500.00 | 1053418137 - TRI-CITY REGIONAL SURGERY CENTER LLC | 911728399 - (WA) TRI-CITY REGIONAL SURGERY CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $353.00 | 1598700676 - FLORIDA EYE INSTITUTE SURGICENTER LLC | 134232690 - (FL) FLORIDA EYE INSTITUTE SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44206 | $464.00 | 1346596566 - SCP INDIANAPOLIS LLC | 460639908 | IN | 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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