CPT 44213 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 80 - Assistant surgeon |
| Complexity Level | Moderate |
| CMS | $179.20 Physician Fee Schedule |
National average reimbursement for CPT 44213 by major payers:
$223.41
$254.43
$268.49
$317.39
| 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 44213 | ||||||
United | 44213 | $477.00 | 1871529388 - PRG DALLAS ASC, LLC, CENTRAL POINT SURGERY CENTER | 752835144 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $983.00 | 1548241623 - GASTROENTEROLOGY ASSOCIATES, LLC, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER | 912104493 - (WA) GASTROENTEROLOGY ASSOCIATES PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $3348.22 | 1508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $507.00 | 1013924133 - TRINITY DEVELOPMENT, LLC, SOUTH ALABAMA OUTPATIENT SERVICES | 721376946 - (AL) TRINITY DEVELOPMENT LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $1049.00 | 1992250922 - MIAMI SURGICAL SUITES LLC | 474339341 - (FL) MIAMI SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $717.00 | 1508869645 - FRESNO CA ENDOSCOPY ASC, LP, CENTRAL CALIFORNIA ENDOSCOPY CENTER | 912127626 - (CA) FRESNO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $565.00 | 1639142706 - AMBULATORY SURGERY CENTER LLC, AMBULATORY SURGERY CENTER | 311545306 - (KY) AMBULATORY SURGERY CENTER LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $492.00 | 1275639023 - SURGICAL CENTER OF BURLINGTON COUNTY, INC | 202116181 - (NJ) SURGICAL CENTER OF BURLINGTON COUNTY INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $2575.00 | 1104947357 - TARRANT COUNTY SURGERY CENTER LP | 710985084 - (TX) TARRANT COUNTY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $880.00 | 1750343083 - LEXINGTON SURGERY CENTER LTD | 611028180 - (KY) LEXINGTON SURGERY CENTER LTD | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $131.00 | 1750434759 - TOWER OAKS SURGERY CENTER, LLC | 204877029 - (MD) TOWER OAKS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $1291.00 | 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 | 44213 | $512.00 | 1093276859 - JACKSONVILLE OUTPATIENT SURGERY CENTER, LLC | 833910772 - (FL) JACKSONVILLE OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $682.00 | 1194083824 - PROVIDENCE FACEY MEDICAL FOUNDATION, FACEY ENDOSCOPY CENTER | 954322584 - (CA) PROVIDENCE FACEY MEDICAL FOUNDATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44213 | $1899.00 | 1275687873 - DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | 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 44213 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44213 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 44213 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 |
|---|---|---|
| 44139-CPT | Low | Mobilization (Take-Down) Of Splenic Flexure Performed In Conjunction With Partial Colectomy (List Separately In Addition To Primary Procedure) |
| 44204-CPT | High | Laparoscopy, Surgical; Colectomy, Partial, With Anastomosis |
| 44205-CPT | High | Laparoscopy, Surgical; Colectomy, Partial, With Removal Of Terminal Ileum With Ileocolostomy |
| 44213-CPT | Moderate | Laparoscopy, Surgical, Mobilization (Take-Down) Of Splenic Flexure Performed In Conjunction With Partial Colectomy (List Separately In Addition To Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44213. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44213 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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