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See a sample rate comparisonCPT 44605 Fee Schedule
Last Verified: October 2026
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.
Surgery On Large Intestine, Surgery On The Large Intestine To Repair An Injury Or Rupture Such As From An Ulcer. The Procedure May Include Creating An External Drainage Pouch (Colostomy).
| 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 | 59 - Distinct Procedural Service 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | $1,217.80 national non-facility rate (2026) · View Medicare rates for 44605 |
| Medicaid Fee Schedule | $947.595 median of the 8 states in the free preview · View Medicaid rates for 44605 |
National average reimbursement for CPT 44605 by major payers:
$1,564.03
$1,731.87
$1,779.11
$2,058.91
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CPT 44605
5 of 25 sample ratesHigher to lower in this preview
Gramercy Surgery Center, Ltd
$2,785.00Published rateNorthwest Surgery Center, LLP, Northwest Surgery Center
Northwest Surgery Center LLP
$1,028.00Published ratePearl Road Surgery Center, LLC
Pearl Road Surgery Center LLC
$718.00Published rateVirgil V. Willard, II Md PA, Center For Image Discovery PA
Virgil V Willard II Md PA
$488.00Published rateDh Physicians Ambulatory Services
$350.00Published rate
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See a sample payer proposalCPT 44605 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44605 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 44605 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 |
|---|---|---|
| 44322-CPT | High | Surgery For Colon Opening, Surgery To Create An Opening In The Abdominal Wall For Waste From The Intestines. The Procedure Includes Taking Several Samples Of Tissue For Testing (Biopsies). |
| 44388-CPT | Moderate | Intestinal Exam (Colonoscopy), An Exam Of The Lower Part Of The Intestine (Colon) Using A Scope (Colonoscopy). The Procedure May Include Collection Of Cells Or Tissue For Testing (Biopsy). |
| 44500-CPT | Low | Intro Of Long Gastrointes Tube (Eg Miller-Abbott) (Sepa, Introduction Of Long Gastrointestinal Tube (Eg Miller-Abbott) (Separa |
| 44605-CPT | High | Surgery On Large Intestine, Surgery On The Large Intestine To Repair An Injury Or Rupture Such As From An Ulcer. The Procedure May Include Creating An External Drainage Pouch (Colostomy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44605 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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