Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 44405 Fee Schedule
Last Verified: October 2026
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.
Colonoscopy W/Dilation, Balloon Dilation Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy)
| 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 | PT - Colorectal cancer screening test; converted to diagnostic test or other procedure 53 - Discontinued procedure 52 - Reduced Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $614.58 national non-facility rate (2026) · View Medicare rates for 44405 |
| Medicaid Fee Schedule | $487.865 median of the 8 states in the free preview · View Medicaid rates for 44405 |
National average reimbursement for CPT 44405 by major payers:
$683.62
$780.02
$736.51
$370.20
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 44405.
CPT 44405
5 of 25 sample ratesHigher to lower in this preview
Rabia Shakeel
Kelsey-Seybold Medical Group PLLC
$1,727.38Published rateSandeep Patel
$876.84Published rateLevi Hubble
Scott & White Clinic
$789.51Published rateNathaniel Avila
$631.60Published rateSunil Reddy
$459.35Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 44405 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44405 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 44405 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 |
|---|---|---|
| 44401-CPT | High | Colonoscopy With Ablation, Destruction Of Tissue Abnormalities Tumors Or Polyps Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44403-CPT | Moderate | Colonoscopy W/Resection, Removal Of Lining Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44404-CPT | Moderate | Colonoscopy W/Injection, Injections Beneath Lining Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
| 44405-CPT | Moderate | Colonoscopy W/Dilation, Balloon Dilation Of Large Bowel Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel From Body Wall (Colostomy) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44405. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44405 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 44405) and we'll show you how you compare in 15 minutes or less.