CPT 44316 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 • 59 - Distinct Procedural Service • 78 - Return to OR - related procedure |
| Complexity Level | High |
| CMS | $1,380.55 Physician Fee Schedule |
National average reimbursement for CPT 44316 by major payers:
$1,705.77
$1,872.37
$1,947.85
$2,288.89
| 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 44316 | ||||||
United | 44316 | $623.00 | 1316536352 - UROLOGICAL INSTITUTE OF MARYLAND | 352636464 - (MD) UROLOGICAL INSTITUTE OF MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $464.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $170.00 | 1265966444 - CHILDREN'S SURGERY CENTER OF LEHIGH VALLEY, LLC | 611830897 - (PA) CHILDRENS SURGERY CENTER OF LEHIGH VALLEY LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $800.00 | 1629045133 - MONTICELLO COMMUNITY SURGERY CENTER, LLC, UVA HEALTH SURGICAL CARE RIVERSIDE | 113656095 - (VA) MONTICELLO COMMUNITY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $950.00 | 1457087926 - SPOKANE UROLOGY, PLLC, UROLOGY SURGERY CENTER NORTHWEST | 911043589 - (WA) SPOKANE UROLOGY, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $508.00 | 1134777832 - PETERS ENDOSCOPY CENTER, LLC | 842583326 - (NC) PETERS ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $1028.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $846.00 | 1376885400 - MD ANAHEIM SURGERY CENTER INC | 462311690 - (CA) MD ANAHEIM SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $1344.00 | 1194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC | 223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $817.00 | 1952698078 - EXECUTIVE SURGERY CENTER, INC. | 452484347 - (CA) EXECUTIVE SURGERY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $1350.00 | 1235551052 - LONG ISLAND DIGESTIVE ENDOSCOPY CENTER, LLC | 454714972 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $330.00 | 1497159255 - SURGICAL CENTER OF PONTE VEDRA BEACH, LLC | 472133947 - (FL) SURGICAL CENTER OF PONTE VEDRA B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $1028.00 | 1811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $788.00 | 1609375682 - LUTHERVILLE SURGERY CENTER, LLC | 823355711 - (MD) LUTHERVILLE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44316 | $103.00 | 1659343648 - SWAGEL-WOOTTON EYE CENTER, INC, EYE SURGERY CENTER OF ARIZONA | 860555229 - (AZ) SWAGEL/WOOTTON EYE CENTER, LTD. | AZ | 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 44316 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44316 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 44316 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 44316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44316 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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