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 |
| CMS | $219.63 Physician Fee Schedule |
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 | $1132.00 | 1093079196 - MERCY HOSPITALS EAST COMMUNITIES, MERCY OUTPATIENTSURGERY CENTER WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $925.15 | 1396990701 - PEACEHEALTH, ST JOSEPH MEDICAL CENTER | 910565889 - PEACEHEALTH ST JOSEPH MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1230.00 | 1346624665 - WESTGREEN SURGICAL CENTER LLC, HOUSTON ORTHOPEDIC & SPINE SURGERY CENTER | 474468184 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $2209.00 | 1578558763 - HUNT MEMORIAL HOSPITAL DISTRICT, HUNT REGIONAL HEALTHCARE | 751277293 - (TX) HUNT MEMORIAL HOSPITAL DISTRICT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1353.00 | 1700502150 - MOUNT PLEASANT OUTPATIENT SURGERY CENTER LLC | 883714959 - (SC) MOUNT PLEASANT OUTPATIENT SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $645.00 | 1043361587 - CENTER FOR ASSISTED REPRODUCTION LABORATORY AND SURGERY CENTER, INC. | 752829914 - (TX) CENTER FOR ASSISTED REPRODUCTION LABORATORY AND SURGERY CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1050.00 | 1841759040 - BEAVER VALLEY AMBULATORY SURGERY CENTER, LLC | 822918272 - (PA) BEAVER VALLEY AMBULATORY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $530.00 | 1942292073 - SOUTHERN OKLAHOMA SURGICAL CENTER INC | 731205988 - (OK) SOUTHERN OKLAHOMA SURGICAL CENTER, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $449.00 | 1205266632 - ARKANSAS RENAL GROUP PA, OUACHITA PROCEDURE CENTER | 453592104 - (AR) ARKANSAS RENAL GROUP PA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $1179.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $523.00 | 1518070879 - EHLERS EYE SURGERY LLC | 270079770 - (WA) EHLERS EYE SURGERY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $594.00 | 1699256404 - LEGACY SURGERY CENTER LLC | 831722822 - (FL) LEGACY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $347.00 | 1609039056 - FARSHID PAYDAR MD PC, THE EYE CLINIC | 454779006 - (AZ) FARSHID PAYDAR MD PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44406 | $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 | 44406 | $550.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | 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 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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