CPT 44955 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • AS - PA/NP/CNS assistant at surgery • 80 - Assistant surgeon |
| Complexity Level | Low |
| CMS | $80.54 Physician Fee Schedule |
National average reimbursement for CPT 44955 by major payers:
$109.65
$114.09
$124.57
$138.44
| 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 44955 | ||||||
United | 44955 | $113.00 | 1588152920 - SPECIALTY SURGICAL CENTER, LLC | 352617906 - (MS) SPECIALTY SURGICAL CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $318.00 | 1326469172 - EHI SURGERY CENTER AUSTIN, LLC | 464266877 - (TX) EHI SURGERY CENTER AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $531.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $225.00 | 1679001028 - CENTERVIEW SURGERY CENTER, LLC | 815461133 - (AR) CENTERVIEW SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $2965.00 | 1679523351 - SURGERY CENTER OF PORT CHARLOTTE LTD | 201327093 - (FL) SURGERY CENTER OF PORT CHARLOTTE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $1471.00 | 1508974353 - SOUTHLAKE AMBULATORY SURGERY CENTER, LLLP, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $186.00 | 1740831437 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $100.00 | 1205874906 - CENTRAL GA HEAD &NECK SURGERY CENTER | 582379919 - (GA) CENTRAL GA HEAD NECK SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $140.00 | 1619517539 - MOUNTAIN WEST DERM | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $151.00 | 1093146771 - NORTHWEST COMMUNITY DAY SURGERY CENTER II LLC | 300798249 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $145.00 | 1912627712 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | 883537315 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $89.00 | 1568083103 - COLUMBIA PARKWAY SURGERY CENTER LLC | 850692755 - (MD) COLUMBIA PARKWAY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $420.00 | 1467472688 - WEST CLINIC ASTC, WEST CLINIC, PC | 621526296 - THE WEST CLINIC, PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $1446.00 | 1386882587 - BAYLOR SURGICARE AT GRANBURY LLC, BAYLOR SCOTT & WHITE SURGICARE-GRANBURY | 263896477 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 44955 | $150.00 | 1255792453 - MIDWEST EYE CONSULTANTS OHIO, INC, CATARACT & LASER INSTITUTE #351 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | 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 44955 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44955 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 44955 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 |
|---|---|---|
| 44900-CPT | Moderate | I & D Of Appendiceal Abscess, Transabdom |
| 44950-CPT | Moderate | Appendectomy |
| 44955-CPT | Low | Appendectomy; When Done For Indicated Purpose At Time Of Other Major Procedure (Not As Separate Procedure) (List Separately In Addition To Code For Primary Procedure) |
| 44960-CPT | High | Appendectomy W Ruptured Appendix |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44955. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44955 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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