CPT 44603 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 • 23 - Emergency Room |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| CMS | $1,569.45 Physician Fee Schedule |
National average reimbursement for CPT 44603 by major payers:
$1,922.14
$2,101.93
$2,214.24
$2,579.30
| 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 44603 | ||||||
United | 44603 | $2387.00 | 1356643944 - UNION SURGERY CENTER, LLC | 272373691 - (NJ) UNION SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $1064.00 | 1821036138 - GAMMA SURGERY CENTER LLC | 270128900 - (PA) GAMMA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $550.00 | 1841605318 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC, FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER-CITRUS PARK | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $410.00 | 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 | 44603 | $400.00 | 1508896705 - TIFTAREA ENDOSCOPY CENTER, INC. | 582394224 - (GA) TIFTAREA ENDOSCOPY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $604.00 | 1447991138 - SILVER STATE SURGERY CENTER WEST LLC | 872764352 - (NV) SILVER STATE SURGERY CENTER WEST LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $1064.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $1061.00 | 1720407273 - BRONX SC LLC, EMPIRE STATE AMBULATORY SURGERY CENTER | 273045919 - (NY) BRONX SC LLC DBA EMPIRE STATE AMBULATORY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $1064.00 | 1790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP | 810587498 - (AZ) METRO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $285.00 | 1730382789 - ENDOSCOPY CENTER | 260317060 - (NC) ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $450.00 | 1780958207 - LANCASTER SURGERY CENTER, INC. | 320361416 - (OH) LANCASTER SURGERY CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $475.00 | 1275199978 - RAC SURGERY CENTER LLC | 831302565 - (NC) RAC SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $299.00 | 1659594307 - EYE SURGERY CENTER OF NORTHERN NEVADA, LLC | 205368967 - (NV) EYE SURGERY CENTER OF NORTHERN NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $1028.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44603 | $1747.00 | 1083902423 - CHASKA PLAZA SURGERY CENTER, LLC, TWO TWELVE SURGERY CENTER | 450975783 - (MN) CHASKA PLAZA SURGERY CENTER LLC | MN | 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 44603 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44603 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 44603 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 |
|---|---|---|
| 44392-CPT | Moderate | Removal Of Growths Or Polyps Of Large Bowel By Electrical Cautery Using An Endoscope Inserted Through Surgically Created Opening From Large Bowel To Skin |
| 44394-CPT | Moderate | Removal Of Growths Or Polyps Of Large Bowel By Mechanical Snare Using An Endoscope Inserted Through Surgically Created Opening Into Large Bowel To Skin |
| 44602-CPT | High | Suture Of Small Intestine (Enterorrhaphy) For Perforated Ulcer, Diverticulum, Wound, Injury, Or Rupture; Single Perforations |
| 44603-CPT | High | Suture Of Small Intestine (Enterorrhaphy) For Perforated Ulcer, Diverticulum, Wound, Injury, Or Rupture; Multiple Perforations |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44603. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44603 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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