CPT 44394 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 22 - On Campus Outpatient Hospital |
| Common Modifiers | None PT - Colorectal cancer screening test; converted to diagnostic test or other procedure 33 - Preventive Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 44394 |
National average reimbursement for CPT 44394 by major payers:
$554.19
$599.03
$641.11
$396.89
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 44394 | $1345.00 | 1215111869 - SPECIALTY SURGERY CENTER AT FOUNTAIN VALLEY REGIONAL HOSPITAL LLC | 371756991 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $268.00 | 1457320962 - FOOT AND ANKLE CENTER AT THE BURKLAND MEDICAL CENTER INC. | 522160415 - (MD) FOOT AND ANKLE CENTER AT THE BURKLAND MEDICAL CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1276.00 | 1235395385 - TENN SM LLC | 680569923 - (TN) TENN SM LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $660.00 | 1790936847 - RSC SURGERY CENTER, LLC | 352345966 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $960.00 | 1245239656 - SURGERY CENTER OF GILBERT LLC, SURGERY CENTER OF GILBERT | 731596190 - (AZ) SURGERY CENTER OF GILBERT, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $915.00 | 1154318103 - OPTUM CARE WASHINGTON PLLC, OPTUM - KEMP SURGERY CENTER | 910214500 - THE EVERETT CLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1955.00 | 1124083076 - NORTH GARLAND SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - NORTH GARLAND | 562399993 - (TX) NORTH GARLAND SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1290.00 | 1104189042 - FOOTHILLS SURGERY CENTER, LLC | 455328252 - (CO) FOOTHILLS SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $873.00 | 1508840893 - PARKWAY SURGERY CENTER | 621799370 - (SC) PARKWAY SURGERY CENTER, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1666.00 | 1194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC | 223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $839.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $941.00 | 1891186987 - FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTER,LLC | 464426708 - (CO) FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTERLLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1650.00 | 1457385668 - RAVINE WAY SURGERY CENTER, LLC | 201245279 - (IL) RAVINE WAY SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1233.00 | 1093985525 - SURGERY CENTER OF CORAL GABLES LLC, CORAL GABLES SURGERY CENTER | 204843518 - (FL) SURGERY CENTER OF CORAL GABLES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44394 | $1276.00 | 1275198673 - UROLOGY ASC- PHOENIX, LLC, UROLOGIC SURGERY CENTER OF ARIZONA | 320586987 | 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 44394 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44394 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 44394 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 |
|---|---|---|
| 44390-CPT | Moderate | Colonoscopy For Foreign Body, Removal Of Foreign Bodies From Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44392-CPT | Moderate | Colonoscopy & Polypectomy, Removal Of Tissue Abnormalities Tumors Or Polyps Of Large Bowel By Hot Biopsy Forceps Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44394-CPT | Moderate | Colonoscopy W/Snare, Removal Of Tissue Abnormalities Tumors Or Polyps Of Large Bowel By Snare Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44602-CPT | High | Suture Of Small Intestine (Ent, Suture Of Small Intestine (Enterorrhaphy) For Perforatedulcer Diverticulum Wound Injury Or Rupture Single Perforation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44394. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44394 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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