CPT 44970 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • AG - Primary physician |
| Complexity Level | Moderate |
| CMS | $591.62 Physician Fee Schedule |
National average reimbursement for CPT 44970 by major payers:
$740.79
$796.85
$874.64
$985.69
| 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 44970 | ||||||
United | 44970 | $2588.20 | 1598262636 - EMILY SKEEN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Pulmonology Physician (2080P0214X) |
United | 44970 | $2454.33 | 1407020951 - THERESA CHIN | 330503714 | CA | Surgery Physician (208600000X) |
United | 44970 | $745.90 | 1053503599 - LISA SCHLITZKUS | 840782874 - (CO) PATHWAYS HOSPICE | CO | Surgical Critical Care Physician (2086S0102X) |
United | 44970 | $2537.45 | 1982073482 - NATHAN KUPPERSTOCK | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | 44970 | $2221.22 | 1518428143 - GREGORY ADAMS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | OH | Emergency Medicine Physician (207P00000X) |
United | 44970 | $2032.50 | 1053731109 - ERIC NAU | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Emergency Medicine (Pediatrics) Physician (2080P0204X) |
United | 44970 | $2177.66 | 1801845433 - CARA WYLIE | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Podiatrist (213E00000X) |
United | 44970 | $2221.22 | 1124086178 - NEENA THOMAS-GOSAIN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | WI | Infectious Disease Physician (207RI0200X) |
United | 44970 | $1780.01 | 1720600604 - JUAN SALGADO | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Anesthesiology Physician (207L00000X) |
United | 44970 | $2032.50 | 1154784973 - ABIGAIL RUSS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Emergency Medicine (Pediatrics) Physician (2080P0204X) |
United | 44970 | $1735.82 | 1366897019 - GABRIELLE WHITMORE | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Obstetrics & Gynecology Physician (207V00000X) |
United | 44970 | $1780.01 | 1033193115 - DANIEL DOBLER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Emergency Medicine Physician (207P00000X) |
United | 44970 | $2537.45 | 1043204241 - DENA ROSS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Hospitalist Physician (208M00000X) |
United | 44970 | $2177.66 | 1760623417 - MATTHEW IORIO | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Surgery of the Hand (Plastic Surgery) Physician (2082S0105X) |
United | 44970 | $2447.60 | 1245657261 - KRYSTLE TUANO | 42697983 - MASS GENERAL BRIGHAM INCORPORATED | MA | Plastic and Reconstructive Surgery Physician (2086S0122X) |
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 44970 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44970 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 44970 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 |
|---|---|---|
| 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 |
| 44970-CPT | Moderate | Laparoscopy; Appendectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44970 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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