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See a sample rate comparisonHealthcare 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 | 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $210.43 national non-facility rate (2026) · View Medicare rates for 44366 |
| Medicaid Fee Schedule | $171.52 median of the 8 states in the free preview · View Medicaid rates for 44366 |
National average reimbursement for CPT 44366 by major payers:

$321.15

$334.66

$359.15

$400.98
Choose a payer to see a sample of rates for CPT 44366.
Penn Presbyterian Medical Center Spu
Presbyterian Medical Center Of The University Of Pennsylvania Health
Wellington Endoscopy Center LLC
Day Surgery Limited Liability
Day Surgery LLC
Millenia Surgery Center LLC
Millenia Surgery Center
E. Ronald Salvitti, M.D., Inc., Southwestern PA Eye Surgery Center
E. Ronald Salvitti, M.D., Inc.
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 44366 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44366 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 44366 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 Bowel Endoscopy Biopsy, Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum With Biopsy Single Or Multiple |
| 44364-CPT | Moderate | Small Intestinal Endoscopy En, Small Intestinal Endoscopy Enteroscopy Beyond Secondportion Of Duodenum Not Including Ileum With Removal Of Tumor(S) Polyp(S) Or Other Lesion(S)By Snare Technique |
| 44366-CPT | Moderate | Small Bowel Endoscopy, Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum With Control Of Bleeding Eg Injection Bipolar Cautery Unipolar Cautery Laser Heater Probe Stapler Plasma Coagulator |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44366. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44366 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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