CPT 44406 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 |
| Common Modifiers | • None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 44406 |
National average reimbursement for CPT 44406 by major payers:
$317.69
$323.12
$323.63
$410.95
| 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 44406 | ||||||
United | 44406 | $799.00 | 1164012142 - COMPREHENSIVE DIGESTIVE SURGICENTER, LLC, COMPREHENSIVE DIGESTIVE SURGICAL CENTER | 854015524 - (NV) COMPREHENSIVE DIGESTIVE SURGICENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $638.00 | 1316946106 - CHARLESTON ENDOSCOPY CENTER | 571104687 - (SC) CHARLESTON ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1092.00 | 1962958223 - NORTHGLENN ENDOSCOPY CENTER LLC | 812984347 - (CO) NORTHGLENN ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $611.00 | 1457784852 - SMART PAIN SURGERY CENTER AT OWINGS MILLS, LLC, CLEARWAY SURGERY CENTER OF OWINGS MILLS | 454995677 - (MD) SMART PAIN SURGERY CENTER AT OWINGS MILLS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $639.00 | 1801822739 - SYLVAN SURGERY CENTER, INC. | 200500901 - (CA) SYLVAN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $725.00 | 1639696529 - NORTH ATLANTA EAR, NOSE & THROAT SURGICAL CENTER, LLC | 814394384 - (GA) NORTH ATLANTA EAR NOSE THROAT SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1276.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $900.00 | 1750343083 - LEXINGTON SURGERY CENTER LTD | 611028180 - (KY) LEXINGTON SURGERY CENTER LTD | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $600.00 | 1396266441 - EYE SURGERY CENTER OF EAST TEXAS LLC | 811881035 - (TX) EYE SURGERY CENTER OF EAST TEXAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $565.00 | 1427098201 - LAKE AREA SURGICARE LLC, SURGICARE OF LAKE CHARLES | 621658994 - (LA) LAKE AREA SURGICARE LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1258.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $764.00 | 1730487083 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $2392.00 | 1093120859 - PARK HILL SURGERY CENTER, LLC | 451484375 - (TX) PARK HILL SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $3008.00 | 1700431798 - METHODIST AMBULATORY SURGERY CENTER OF BOERNE, LLC | 823532569 - (TX) METHODIST AMBULATORY SURGERY CENTER OF BOERNE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $912.00 | 1528060704 - CMMP SURGICAL CENTER LLC | 431709558 - (MO) CMMP SURGICAL CENTER | MO | 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 44406 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44406 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 44406 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 Through Stoma; Diagnostic, Including Collection Of Specimenss By Brushing Or Washing When Performed With Ablation Of Tumors, Polyps, Or Other Lesionss Inc |
| 44402-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimenss By Brushing Or Washing When Performed, With Endoscopic Stent Placement Including Pre And Post-Dil |
| 44403-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimens(S) By Brushing Or Washing When Performed; With Endoscopic Mucosal Resection |
| 44406-CPT | Moderate | Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimens(S) By Brushing Or Washing When Performed; With Endoscopic Ultrasound Examination, Limited To The Sigmo |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44406 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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