CPT 44312 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 • 78 - Return to OR - related procedure • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $583.85 Physician Fee Schedule |
National average reimbursement for CPT 44312 by major payers:

$745.39

$781.19

$838.40

$970.96
| 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 44312 | ||||||
United | 44312 | $565.00 | 1023055001 - ZION AMBULATORY CENTER LLC | 203243084 - (MD) ZION AMBULATORY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $2117.00 | 1689986879 - DEER POINTE SURGICAL CENTER, LLC, POA SURGERY CENTER | 272384315 - (MD) DEER POINTE SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $1646.00 | 1588274963 - WILMINGTON EYE SURGERY CENTER, LLC | 842465908 - (NC) WILMINGTON EYE SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $717.00 | 1194832949 - CHOICES WOMEN'S MEDICAL CENTER, INC. | 112715115 - CHOICES WOMENS MEDICAL CENTER IN | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $1300.00 | 1194718940 - 20-20 SURGERY CENTER LLC | 331066427 - (PA) 2020 SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $856.00 | 1578535233 - SUN CITY OPHTHALMOLOGY ASC LLC, EYE INSTITUTE AT BOSWELL | 621737549 - (AZ) SUN CITY OPHTHALMOLOGY ASSOC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $1800.00 | 1083382154 - TRI-CITY SURGICAL CENTERS, LLC | 825357044 - (AZ) TRICITY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $2170.00 | 1932285111 - ORTHOVIRGINIA OPERATORY | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $2075.00 | 1285399410 - NEAMAN SURGERY CENTER, LLC | 862826028 - (OR) NEAMAN SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $510.00 | 1073579256 - OUTPATIENT SURGICAL CARE LTD | 860525610 - (AZ) OUTPATIENT SURGICAL CARE LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $2080.00 | 1952776098 - BAYTOWN ASC, LP, BAYTOWN HEART & VASCULAR SURGERY CENTER | 474501044 - (TX) BAYTOWN ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $2540.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $1750.00 | 1154590271 - UNITY SURGICAL CENTER, LLC, UNITY SURGICAL CENTER | 352099067 - (IN) UNITY SURGICAL CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $1009.00 | 1891309423 - KINGSLEY ENDOSCOPY CENTER LLC | 843425039 - (FL) KINGSLEY ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44312 | $3623.00 | 1184680225 - CAPITAL CITY SURGICAL CENTER LLC, CAPITAL CITY SURGICAL CENTER LLC | 471211202 | FL | 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 44312 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44312 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 44312 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44312 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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