CPT 44378 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XS - Separate Structure |
| Complexity Level | Moderate |
| CMS | $366.49 Physician Fee Schedule |
National average reimbursement for CPT 44378 by major payers:
$525.95
$533.04
$565.31
$649.40
| 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 44378 | ||||||
United | 44378 | $1886.00 | 1073613162 - ROCKY MOUNTAIN SURGERY CENTER LLC | 870699657 - (CO) ROCKY MOUNTAIN SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $897.00 | 1457329963 - SEQUOIA SURGERY CENTER, LLC, CYPRESS SURGERY CENTER, A LIMITED PARTNERSHIP | 770326275 - (CA) SEQUOIA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $370.00 | 1598189342 - MEI SURGERY CENTER LLC, MICHIGAN EYE SURGERY CENTER | 461591012 - (MI) MEI SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $1500.00 | 1891049441 - ISLAND DIGESTIVE HEALTH CENTER, LLC | 452411095 - (NY) ISLAND DIGESTIVE HEALTH CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $410.00 | 1255311635 - MELBOURNE ASC LP, THE SURGERY CENTER OF MELBOURNE | 621625311 - (FL) MELBOURNE ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $567.00 | 1174713382 - GREENBRIER CLINIC SURGERY CENTER | 200126880 | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $629.00 | 1467883496 - KILLER BEES LLC, BLUEGRASS SURGERY AND LASER CENTER | 201075292 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $2832.00 | 1710231642 - ADVANCED REGIONAL SURGERY CENTER, LLC | 461072979 - (IN) ADVANCED REGIONAL SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $513.00 | 1184948663 - ASSOCIATED UROLOGISTS AMBULATORY SURGERY CENTER LLC | 272200221 - (KS) ASSOCIATED UROLOGISTS AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $298.00 | 1114906393 - PHYSICIANS SURGERY CENTER LLC | 200435814 - (AR) PHYSICIANS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $788.00 | 1144499633 - FOOTHILL SURGERY CENTER LP | 510453471 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $1528.00 | 1790885895 - UNITED MEDICAL ENDOSCOPY CENTER | 454651695 - (CA) ADVANCED ENDOSCOPY AND PAIN CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $635.00 | 1831413772 - OXFORD UROCARE PLLC | 272032475 - (MS) OXFORD UROCARE PLLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $1258.00 | 1306843222 - ST. JOSEPH'S OUTPATIENT SURGERY CENTER, LLC | 562332449 - (AZ) ST JOSEPHS OUTPATIENT SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44378 | $772.00 | 1700842358 - THE EYE SURGERY CENTER OF THE CAROLINAS LP | 205562797 - (NC) THE EYE SURGERY CENTER OF THE CAROLINAS LP | NC | 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 44378 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44378 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 44378 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 |
|---|---|---|
| 44376-CPT | Moderate | Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Including Ileum; Diagnostic, With Or Without Collection Of Specimen(S) By Brushing Or Washing (Separate Procedure) |
| 44377-CPT | Moderate | Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Including Ileum; With Biopsy, Single Or Multiple |
| 44378-CPT | Moderate | Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Including Ileum; With Control Of Bleeding (Eg, Injection, Bipolar Cautery, Unipolar Cautery, Laser, Heater Probe, Stapler, Plasma Coagulator) |
| 44379-CPT | Moderate | Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Including Ileum; With Transendoscopic Stent Placement (Includes Predilation) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44378. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44378 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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