CPT 44212 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 • 22 - Increased Procedural Services • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| CMS | $1,957.61 Physician Fee Schedule |
National average reimbursement for CPT 44212 by major payers:
$2,512.84
$2,723.46
$2,886.11
$3,341.87
| 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 44212 | ||||||
United | 44212 | $354.00 | 1235112814 - MT PLEASANT SURGICAL CENTER, LLC, MT PLEASANT SURGICAL CENTER | 752691365 - (TX) MT PLEASANT SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $2705.00 | 1104947357 - TARRANT COUNTY SURGERY CENTER LP | 710985084 - (TX) TARRANT COUNTY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $2705.00 | 1548223068 - COLUMBIA SURGICARE OF AUGUSTA, LTD | 621671906 - (GA) COLUMBIA SURGICARE OF AUGUSTA LTD | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $1521.00 | 1396782553 - SSM ST. JOSEPH SURGERY CENTER, LLC, THE SURGERY CENTER AT ST. JOSEPH MEDICAL PARK | 431822767 - (MO) SSM ST JOSEPH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $588.00 | 1588802466 - SALMON CREEK PLASTIC SURGERY PC, SALMON CREEK PLASTIC SURGERY PC/ASC FACILITY | 205914560 - (WA) SALMON CREEK PLASTIC SURGERY, PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $641.00 | 1295288751 - PLASTIC HEAD AND NECK SURGERY INSTITUTE | 812018399 - (GA) PLASTIC HEAD AND NECK SURGERY INSTITUTE | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $100.00 | 1376998666 - SWAN SURGERY CENTER, LLC | 812309409 - (AZ) SWAN SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $7400.00 | 1811172729 - INDIANA ENDOSCOPY CENTERS LLC, INDIANA ENDOSCOPY CENTER WEST | 208398421 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $6068.00 | 1487399168 - WILLOW PARK ENDOSCOPY CENTER, LLC | 881643733 - (TX) WILLOW PARK ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $550.00 | 1255746087 - OSI, LLC | 352509822 - (MI) OSI, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $775.00 | 1679531610 - BOSTON UNIVERSITY EYE ASSOCIATES, INC., BOSTON UNIVERSITY EYE ASSOCIATES SURGERY & LASER CENTER | 43137333 - (MA) BOSTON UNIVERSITY EYE ASSOCIATES INC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $587.00 | 1376692129 - STUART CARDON, CASCADE FOOT AND ANKLE PLLC | 205179809 - (WA) STUART CARDON DBA CASCADE FOOT & | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $2847.00 | 1003119470 - MOUNTAIN WEST SURGERY CENTER, LLC | 371614424 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $2692.00 | 1467415513 - LAS VEGAS SURGICARE LTD | 880244070 - (NV) LAS VEGAS SURGICARE LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44212 | $477.00 | 1326107509 - OMAHA AMBULATORY SURGERY CENTER LLC | 205880863 | NE | 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 44212 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44212 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 44212 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 |
|---|---|---|
| 44146-CPT | High | Colectomy,Partial; W/Coloproctostomy,W/C |
| 44207-CPT | High | Laparoscopy, Surgical; Colectomy, Partial, With Anastomosis, With Coloproctostomy (Low Pelvic Anastomosis) |
| 44210-CPT | High | Laparoscopy, Surgical; Colectomy, Total, Abdominal, Without Proctectomy, With Ileostomy Or Ileoproctostomy |
| 44212-CPT | High | Laparoscopy, Surgical; Colectomy, Total, Abdominal, With Proctectomy, With Ileostomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44212. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44212 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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