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 |
| CMS | $1,024.41 Physician Fee Schedule |
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 | $800.00 | 1659807717 - TAMPA SURGICAL CENTER LLC | 820715188 - (CA) TAMPA SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $534.00 | 1871929646 - NORTHWEST EYELID AND ORBITAL SPECIALISTS PS, NEOS SURGERY CENTER | 272018338 - (WA) NORTHWEST EYELID AND ORBITAL SPECIALISTS PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $1955.00 | 1093079196 - MERCY HOSPITALS EAST COMMUNITIES, MERCY OUTPATIENTSURGERY CENTER WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $110.00 | 1023074291 - ARIZONA EYE INSTITUTE & COSMETIC LASER CENTER LLC | 860950533 - (AZ) ARIZONA EYE INSTITUTE COSMETIC LASER CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $758.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $410.00 | 1548594880 - RIVERSIDE SURGICAL CENTER | 262228384 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $384.00 | 1649233719 - GI ASC LLC | 861122720 - (PA) GI ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $1028.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $2732.00 | 1134183908 - NORTH PALM BEACH COUNTY SURGERY CENTER LLC | 752424900 - (FL) NORTH PALM BEACH COUNTY SURGERY CENTER LLC | FL | 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 | $100.00 | 1417114166 - STONECREEK SURGERY CENTER LLC | 412275749 - (NV) STONECREEK SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $718.00 | 1508911728 - MINIMALLY INVASIVE SURGICAL AND NEUROSCIENCE LLC, DELAWARE OUTPATIENT CENTER FOR SURGERY | 161694674 - (DE) DELAWARE OUTPATIENT CENTER FOR SURGERY | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $840.00 | 1811546575 - FIRST COAST ORTHOPEDIC CENTER, LLC, FIRST COAST SURGERY CENTER | 822929226 - (FL) FIRST COAST ORTHOPEDIC CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44604 | $410.00 | 1104457274 - TEXAS MIDWEST ENDOSCOPY CENTER, LLC | 842574842 - (TX) TEXAS MIDWEST ENDOSCOPY CENTER LLC | TX | 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 | 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 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.
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