CPT 44365 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 | • 24 - Ambulatory Surgical Center • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 44365 by major payers:
$255.80
$253.32
$257.28
$310.13
| 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 44365 | ||||||
United | 44365 | $683.00 | 1750414983 - ROCKLEDGE SURGERY CENTER, INC. | 522098503 - (MD) ROCKLEDGE SURGERY CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $650.00 | 1659451078 - ACADEMY ORTHOPEDICS, LLC, DBA ACADEMY ORTHOPEDICS, LLC, AMBULATORY SURGICAL CENTER | 582383939 - (GA) ACADEMY ORTHOPEDICS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $670.00 | 1750352324 - SUNRISE AMBULATORY SURGICAL CENTER LLC | 943363471 - (AZ) SUNRISE AMBULATORY SURGICAL CENT | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $705.00 | 1801949631 - THIBODAUX SURGERY CENTER, LLC, BAYOU REGION SURGICAL CENTER | 320165642 - (LA) THIBODAUX SURGERY CENTER, LLC DBA BAYOU REGION SURGICAL CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $455.00 | 1518155811 - THE ALTAMONTE SPRINGS FL ENDOSCOPY ASC LLC, PALM ENDOSCOPY CENTER | 260289067 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $1168.00 | 1992788384 - ASPEN SURGERY VENTURE LLC, ASPEN SURGERY CENTER | 263913327 - (CA) ASPEN SURGERY VENTURE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $303.00 | 1598965634 - LAKE CITY SURGERY CENTER, LLC | 260811545 - (FL) LAKE CITY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $1116.00 | 1316926405 - MIRACLE HILLS SURGERY CENTER LLC | 204464406 - (NE) MIRACLE HILLS SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $850.00 | 1134779622 - HELIX SURGICENTER LLC | 834455797 - (IN) HELIX SURGICENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $517.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $1020.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $1528.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $819.00 | 1093146771 - NORTHWEST COMMUNITY DAY SURGERY CENTER II LLC | 300798249 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $601.00 | 1023043445 - AESTHETIC EYE ASSOCIATES, PS, ALLURE LASER CENTER & MEDISPA | 911577091 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44365 | $947.00 | 1386275147 - SURGERY CENTER OF MESA LLC | 813829555 - (AZ) SURGERY CENTER OF MESA LLC | 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 44365 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44365 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 44365 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 | 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) |
| 44363 | Moderate | Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum; Withremoval Of Foreign Body(S) (Desc Revised 01/01/15) |
| 44364 | 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 |
| 44365 | 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 Hot Biopsy Forceps Or Bipolar Cautery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44365. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44365 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
|---|