CPT 44604 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 • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 44604 |
National average reimbursement for CPT 44604 by major payers:
$1,277.79
$1,406.37
$1,495.15
$1,715.60
| 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 44604 | ||||||
United | 44604 | $500.00 | 1639431653 - DESERT CLIFFS SURGERY CENTER LLC | 800824134 - (AZ) DESERT CLIFFS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $4300.00 | 1215134564 - EMMAUS SURGICAL CENTER, LLC | 208939316 - (NJ) EMMAUS SURGICAL CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $1049.00 | 1912265653 - BRASELTON ENDOSCOPY CENTER, LLC | 453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $100.00 | 1316375884 - OXON HILL UROLOGY SURGERY CENTER PC | 463746777 - (MD) OXON HILL UROLOGY SURGERY CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $785.00 | 1528480076 - SOUTH ATLANTA AMBULATORY SURGICAL CENTER, LLC | 462848445 - (GA) SOUTH ATLANTA AMBULATORY SURGICAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $400.00 | 1487014361 - GRIFFIN CENTER FOR PAIN AND SPINE | 814348805 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $639.00 | 1932782315 - WAKE SPINE AND SPECIALTY SURGERY CENTER LLC, RALEIGH NEUROSURGICAL AND SPINE SURGERY CENTER | 842694789 - (NC) WAKE SPINE & SPECIALTY SURGERY | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $2847.00 | 1669415451 - BOUNTIFUL SURGERY CENTER LLC | 364581088 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $550.00 | 1164662912 - SPACE COAST SURGERY CENTER LLC | 263184352 - (FL) SPACE COAST SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $410.00 | 1548594880 - RIVERSIDE SURGICAL CENTER | 262228384 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $673.00 | 1962531988 - PIEDMONT SURGERY CENTER | 581874926 - (GA) PIEDMONT SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $381.00 | 1710924881 - GEORGIA DERMASURGERY CENTERS, INC. | 582495671 - (GA) GEORGIA DERMASURGERY CENTERS INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $1050.00 | 1972153997 - EASTERN PENNSYLVANIA ENDOSCOPY CENTER, LLC | 842257961 - (PA) EASTERN PENNSYLVANIA ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $608.00 | 1336375930 - JACKSON SURGERY CENTER, LLC | 204173305 - (AL) JACKSON SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $461.00 | 1083030597 - TRIAD SURGERY CENTER, LLC, TRIAD EYE INSTITUTE | 473510624 | OK | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 44604 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44604 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 44604 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 |
|---|---|---|
| 44345-CPT | High | Revise Colostomy Complicated |
| 44346-CPT | High | Revision Colostomy; W/Rep Paracolostomy |
| 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 |
| 44604-CPT | High | Suture Of Large Intestine (Colorrhaphy) For Perforated Ulcer Diverticulum Wound Injury Or Rupture (Single Or Multiple Perforations); Without Colostomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44604 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 44604) and we'll show you how you compare in 15 minutes or less.