CPT 44364 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $195.37 Physician Fee Schedule |
National average reimbursement for CPT 44364 by major payers:
$275.06
$284.86
$306.17
$348.45
| 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 44364 | ||||||
United | 44364 | $830.00 | 1699855213 - SANTA MONICA SURGICAL PARTNERS LLC, SURGERY CENTER OF THE PACIFIC | 870760381 - (CA) SANTA MONICA SURGICAL PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $830.00 | 1316231020 - DESERT VIEW ENDOSCOPY CENTER, LLC. | 272420135 - (CA) DESERT VIEW ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $300.00 | 1306964853 - GASTROENTEROLOGY ENDOSCOPY CENTER | 582349040 - (GA) GASTROENTEROLOGY ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $445.00 | 1447231287 - GASTROENTEROLOGY SPECIALISTS INC, ENDOSCOPY CENTER | 341773267 - (OH) GASTROENTEROLOGY SPECIALISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $1275.00 | 1346508520 - FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | 270870899 - (NJ) FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $1809.00 | 1144970807 - MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC | 881391141 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $1028.00 | 1205082948 - BECKER PLASTIC SURGERY CENTER | 208056374 - (ND) BECKER PLASTIC SURGERY CENTER, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $500.00 | 1003273129 - GREAT LAKES SURGERY CENTER LLC | 465665524 - (MI) GREAT LAKES SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $584.00 | 1710163670 - PHYSICIAN SURGERY CENTER AT ANMED HEALTH LLC | 570359174 - ANMED HEALTH | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $430.00 | 1982744231 - SOUTHLAND ENDOSCOPY CENTER, SOUTHLAND ENDOSCOPY CENTER | 330607952 - (CA) SOUTHLAND ENDOSCOPY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $375.00 | 1063437994 - TRI-CITIES ENDOSCOPY CENTER PC, THE CENTER FOR DIGESTIVE WELLNESS | 621867929 - (TN) TRICITIES ENDOSCOPY CENTER PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $1258.00 | 1992706899 - SURGERY CENTER OF PEORIA, LLC, SURGERY CENTER OF PEORIA | 731538768 - (AZ) SURGERY CENTER OF PEORIA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $460.00 | 1225414246 - LV SURGERY CENTER LLC | 473021380 - (NV) LV SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $830.00 | 1902964174 - 4TH STREET LASER & SURGERY CENTER INC | 943333271 - (CA) FOURTH STREET LASER & SURGERY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44364 | $1996.00 | 1326097981 - FREDERICKSBURG AMBULATORY SURGERY CENTER, LLC | 562322548 - (VA) FREDERICKSBURG AMBULATORY SURGERY CENTER LLC | VA | 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 44364 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44364 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 44364 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 |
|---|---|---|
| 44360-CPT | Low | Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Separate Procedure) (Desc Revised 01/01/15) |
| 44361-CPT | Moderate | Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Not Including Ileum; With Biopsy, Single Or Multiple |
| 44363-CPT | Moderate | Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum; Withremoval Of Foreign Body(S) (Desc Revised 01/01/15) |
| 44364-CPT | Moderate | Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Not Including Ileum; With Removal Of Tumor(S), Polyp(S), Or Other Lesion(S) By Snare Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44364. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44364 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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