CPT 44385 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 • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $208.64 Physician Fee Schedule |
National average reimbursement for CPT 44385 by major payers:
$259.45
$288.28
$327.42
$368.77
| 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 44385 | ||||||
United | 44385 | $2785.00 | 1922075167 - NORTH CENTRAL METHODIST ASC, LP, METHODIST AMBULATORY SURGERY CENTER NORTH CENTRAL | 742998447 - (TX) NORTH CENTRAL METHODIST ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $580.00 | 1538403670 - FRESNO CA MULTI ASC LP, HERNDON SURGERY CENTER | 461297783 - (CA) FRESNO CA MULTI ASC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1500.00 | 1295848752 - ESSEX SURGICAL ARTS SURGERY CENTER, LLC, MOBILE VASCULAR PHYSICIANS | 202242123 - (NJ) ESSEX SURGICAL ARTS SURGERY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $660.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1955.00 | 1023420577 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY | 470985876 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $580.00 | 1629249172 - NORTH STATE SURGERY CENTERS LP, COURT STREET SURGERY CENTER | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $432.00 | 1043282775 - BALTIMORE ENDOSCOPY ASC LLC, GASTROINTESTINAL DIAGNOSTIC CENTER | 621760110 - (MD) BALTIMORE ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1276.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $639.00 | 1972850808 - LAKE RIDGE AMBULATORY SURGERY CENTER, LLC, LAKE RIDGE SURGERY CENTER | 455347932 - (VA) LAKE RIDGE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1300.00 | 1689059222 - GOLDSTEP AMBULATORY SURGERY CENTER, LLC | 465647464 - (NY) GOLDSTEP AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $393.00 | 1295710317 - CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC | 203520333 - (FL) CENTRAL FLORIDA ENDOSCOPY SURGICAL INSTITUTE OF OCALA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1258.00 | 1346383155 - BRIARCLIFF AMBULATORY SURGERY CENTER LP, BRIARCLIFF SURGERY CENTER | 202852584 - (MO) BRIARCLIFF AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1233.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1233.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44385 | $1258.00 | 1215116611 - UPPER BAY SURGERY CENTER, LLC | 205547410 - (MD) UPPER BAY SURGERY CENTER, LLC | MD | 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 44385 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44385 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 44385 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 |
|---|---|---|
| 44384-CPT | Moderate | Ileoscopy, Through Stoma; Diagnostic, Including Collection Of Specimens By Brushing Or Washing, When Performed, With Placement Of Endoscopic Stent Includes Pre And Post- Di |
| 44385-CPT | Moderate | Endoscopic Evaluation Of Small Intestinal Pouch (Eg Kock Pouch Ileal Reservior [S Or J]; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Desc Revised 01/01/15) |
| 44386-CPT | Moderate | Endoscopic Evaluation Of Small Intestinal Pouch (Eg Kock Pouch Ileal Reservior [S Or J]; Biopsy Single Or Multiple (Desc Revised 01/01/15) |
| 44389-CPT | Moderate | Fiberoptic Colonoscopy Through Colostomy; For Biopsy And/Or Collection Of Specimen By Brushing Or Washing |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44385 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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