CPT 44626 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 • 22 - Increased Procedural Services • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 44626 |
National average reimbursement for CPT 44626 by major payers:
$1,940.30
$2,135.63
$2,292.55
$2,594.95
| 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 44626 | ||||||
United | 44626 | $1093.00 | 1508005976 - SOUTH SHORE SC, LLC | 341997077 - (NY) SOUTH SHORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $446.00 | 1396700944 - WATTS PLASTIC SURGERY ASSOCIATION, P.C. | 161661339 - (NJ) WATTS PLASTIC SURGERY ASSOCIATION PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $374.00 | 1679737043 - FRIENDSHIP SURGERY CENTER | 261779956 - (GA) FRIENDSHIP SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $2575.00 | 1942265780 - SURGICARE OF WICHITA, LLC | 752198375 - (KS) SURGICARE OF WICHITA LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $2154.00 | 1033351119 - SSM ST CLARE SURGICAL CENTER LLC, SSM ST CLARE SURGICAL CENTER | 261439695 - (MO) SSM ST CLARE SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $553.00 | 1881002343 - INNOVATIVE SURGERY CENTER, LLC | 471395981 - (MD) INNOVATIVE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $1028.00 | 1750823886 - LAKE ENDOSCOPY CENTER, LLC | 814225104 - (FL) LAKE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $1776.00 | 1356878052 - PAVILION SURGERY CENTER LLC | 814376492 - (CA) PAVILION SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $350.00 | 1518967082 - NOVAMED SURGERY CENTER OF OAK LAWN, LLC, CENTER FOR RECONSTRUCTIVE SURGERY OF OAK LAWN | 770618674 - (IL) NOVAMED SURGERY CENTER OF OAK LAWN LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $492.00 | 1003888595 - LOUISVILLE ENDOSCOPY CENTER, PLLC, LOUISVILLE ENDOSCOPY CENTER | 611354100 - (KY) LOUISVILLE ENDOSCOPY CENTER PLLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $345.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $1028.00 | 1881013142 - ADVANCED SURGERY CENTER OF TAMPA, LLC | 463891843 - (FL) ADVANCED SURGERY CENTER OF TAMPA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $2692.00 | 1467415513 - LAS VEGAS SURGICARE LTD | 880244070 - (NV) LAS VEGAS SURGICARE LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $616.00 | 1346240751 - ROSWELL CENTER FOR FOOT & ANKLE SURGERY, LLC | 201549920 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44626 | $719.00 | 1194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC | 223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLC | NJ | 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 44626 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44626 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 44626 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 |
|---|---|---|
| 44615-CPT | High | Intestinal Stricturoplasty, W/Wo Dilation, For Intestinal Obstruction |
| 44620-CPT | High | Close Enterostomy |
| 44625-CPT | High | Close Enterostom Resect & Anastomos |
| 44626-CPT | High | Closure Of Enterostomy, Large Or Small Intestine; With Resection And Colorectal Anastomosis (Eg, Closure Of Hartmann Type Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44626 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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