CPT 44211 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 • 11 - Office |
| Common Modifiers | • None • 80 - Assistant surgeon • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| CMS | $2,034.27 Physician Fee Schedule |
National average reimbursement for CPT 44211 by major payers:
$2,689.31
$2,871.98
$3,026.58
$3,531.33
| 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 44211 | ||||||
United | 44211 | $718.00 | 1508911728 - MINIMALLY INVASIVE SURGICAL AND NEUROSCIENCE LLC, DELAWARE OUTPATIENT CENTER FOR SURGERY | 161694674 - (DE) DELAWARE OUTPATIENT CENTER FOR SURGERY | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $500.00 | 1114924651 - CARILION SURGERY CENTER NEW RIVER VALLEY, LLC, CARILION | 800091329 - (VA) CARILION SURGERY CENTER NEW RIVER VALLEY, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $1954.00 | 1447949706 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT BOCA RATON RESEARCH PARK | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $300.00 | 1346233905 - AMBULATORY SURGERY CENTER AT INDIANA EYE CLINIC LLC | 352129461 - (IN) AMBULATORY SURGERY CENTER AT INDIANA EYE CLINIC LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $1028.00 | 1376779561 - SURGICARE OF MIRAMAR LLC | 208552194 - (FL) SURGICARE OF MIRAMAR LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $2575.00 | 1295790327 - ENDOSCOPY OF PLANO, LP, GASTROINTESTINAL ENDOSCOPY CENTER OF PLANO | 201477775 - (TX) ENDOSCOPY OF PLANO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $125.00 | 1841578978 - PHYSICIANS' SURGERY CENTER OF NEVADA LLC | 273741243 - (NV) PHYSICIANS SURGERY CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $1064.00 | 1659625101 - ENDOSCOPY CENTER OF GRAND JUNCTION LLC | 461251610 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $1049.00 | 1912265653 - BRASELTON ENDOSCOPY CENTER, LLC | 453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $2377.00 | 1427055425 - PHYSICIANS PAVILION LP, PHYSICIANS PAVILION SURGERY CENTER | 830619935 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $477.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $100.00 | 1588665269 - RF EYE PC, COCHISE EYE & LASER ASC | 860879991 - (AZ) R.F. EYE, PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $1050.00 | 1134218167 - WASHINGTON ORTHOPAEDIC CENTER, INC, PS | 910905625 - (WA) WASHINGTON ORTHOPAEDIC CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $439.00 | 1770603706 - BIRMINGHAM AMBULATORY SURGICAL CENTER, PLLC, TRUVISTA SURGERY CENTER | 202208179 - (MI) BIRMINGHAM AMBULATORY SURGICAL | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44211 | $1461.00 | 1053381236 - METHODIST SURGERY CENTER GERMANTOWN LP | 621659904 - (TN) METHODIST SURGERY CENTER GERMANTOWN 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 44211 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44211 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 44211 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 |
|---|---|---|
| 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 |
| 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) |
| 44211-CPT | High | Laparoscopy, Surgical; Colectomy, Total, Abdominal, With Proctectomy, With Ileoanal Anastomosis, Creation Of Ileal Reservoir (S Or J), With Loop Ileostomy, Includes 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 44211. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44211 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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