CPT 44401 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • None • PT - Colorectal cancer screening test; converted to diagnostic test or other procedure • 59 - Distinct Procedural Service |
| Complexity Level | High |
| CMS | $2,156.87 Physician Fee Schedule |
National average reimbursement for CPT 44401 by major payers:
$2,336.97
$2,631.44
$3,365.81
$3,583.03
| 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 44401 | ||||||
United | 44401 | $735.00 | 1528021573 - SUMMIT SURGERY CENTER LP | 621777535 - (TN) SUMMIT SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $555.00 | 1053711275 - ASC LONE TREE LLC, ICON SURGERY CENTER OF DENVER | 471652599 - (CO) ASC LONE TREE LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $2064.00 | 1902877715 - AMBULATORY SURGICAL CENTER OF MORRIS COUNTY LLC, RIDGEDALE SURGERY CENTER | 223104481 - (NJ) AMBULATORY SURGICAL CENTER OF MORRIS COUNTY, INC. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $725.00 | 1700424322 - GEORGIA INTERVENTIONAL PAIN | 841727755 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $1607.00 | 1225275688 - MAIN STREET SPECIALTY SURGERY CENTER, LLC | 954813223 - (CA) MAIN STREET SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $595.00 | 1972508174 - VILLAGE SURGICENTER, LIMITED PARTNERSHIP, VILLAGE SURGICENTER OF ERIE | 760555703 - (PA) VILLAGE SURGICENTER LIMITED PARTNERSHIP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $1528.00 | 1811994080 - PACIFIC ENDO-SURGICAL CENTER, LP, PACIFIC ENDO-SURGICAL CENTER | 562387275 - (CA) PACIFIC ENDOSURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $3598.00 | 1083754352 - MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA, MERCY PHILADELPHIA HOSPITAL SHORT PROCEDURE UNIT | 231352191 - (PA) MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $800.00 | 1922438472 - PARK AMBULATORY SURGERY CENTER, LLC | 463665760 - (TX) PARK AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $1179.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $417.00 | 1467582437 - NORTH FLORIDA SURGERY CENTER INC, NORTH FLORIDA SURGERY CENTER | 593377918 - (FL) NORTH FLORIDA SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $1528.00 | 1356621239 - MIDLAND TEXAS SURGICAL CENTER, LLC, TEXAS SURGICAL CENTER, AN AFFILIATE OF MIDLAND MEMORIAL HOSPITAL | 453047741 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $979.00 | 1013425933 - REX SURGERY CENTER OF WAKEFIELD, LLC | 465511168 - (NC) REX SURGERY CENTER OF WAKEFIELD LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $893.00 | 1366456618 - SKYWAY SURGERY CENTER. LLC | 753035490 - (CA) SKYWAY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44401 | $432.00 | 1043282775 - BALTIMORE ENDOSCOPY ASC LLC, GASTROINTESTINAL DIAGNOSTIC CENTER | 621760110 - (MD) BALTIMORE ENDOSCOPY ASC 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 44401 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44401 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 44401 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 |
|---|---|---|
| 44388-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Separate Procedure) (Desc Revised 01/01/15) |
| 44389-CPT | Moderate | Fiberoptic Colonoscopy Through Colostomy; For Biopsy And/Or Collection Of Specimen By Brushing Or Washing |
| 44391-CPT | Moderate | Colonoscopy Through Stoma; With Control Of Bleeding Any Method (Desc Revised 01/01/15) Y Laser Heater Probe Stapler Plasma Coagulator) |
| 44401-CPT | High | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimenss By Brushing Or Washing When Performed With Ablation Of Tumors, Polyps, Or Other Lesionss Inc |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44401. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44401 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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