How much does Medicare pay for CPT 44205?

Medicare allowed an average of $1151.42 per service and paid $916.44 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4448.29, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 44205?

Partial removal of small and large bowel with attachment of small and large bowel using an endoscope. It was billed 1,520 times to 1,520 Medicare beneficiaries by 110 providers in 2024.

Which specialty bills 44205 most?

Colorectal Surgery (Proctology), with 853 services from 61 clinicians. Next are General Surgery, Physician Assistant, Surgical Oncology.

CPT 44205

Partial removal of small and large bowel with attachment of small and large bowel using an endoscope

$1151.42Medicare-allowed amount per service, averaged across 1,520 services

Providers submitted

$4448.29

Asking price, not received

Medicare allowed

$1151.42

The fee schedule figure

Medicare paid

$916.44

Balance is patient coinsurance

Providers submitted an average of $4448.29 for this code and Medicare allowed $1151.42 — 3.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $916.44 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,520
Beneficiaries: 1,520
Providers billing it: 110
Total allowed: $1,750,158

What Medicare pays for CPT 44205

Across 1,520 services billed by 110 providers to 1,520 beneficiaries, Medicare allowed an average of $1151.42 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 44205

Specialty	Services	Beneficiaries	Avg allowed	Providers
Colorectal Surgery (Proctology)	853	853	$1276.88	61
General Surgery	441	441	$1185.07	32
Physician Assistant	103	103	$168.86	8
Surgical Oncology	72	72	$1330.53	5
Nurse Practitioner	37	37	$168.98	3
Vascular Surgery	14	14	$1351.93	1

44205 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Massachusetts	96	$1355.60	$1014.80	6
Arizona	95	$985.60	$786.41	7
Maryland	95	$1271.12	$924.08	7
North Carolina	94	$814.89	$650.71	7
Virginia	88	$1119.11	$881.62	7
New York	74	$1487.83	$1038.56	5
California	70	$1104.43	$792.24	6
Oklahoma	63	$1031.06	$857.03	4
Pennsylvania	61	$1157.67	$857.60	4
Tennessee	61	$1186.14	$1033.16	4
Georgia	61	$1295.46	$1022.57	4
Missouri	55	$975.87	$787.45	4
Texas	54	$992.30	$804.86	4
South Carolina	48	$1232.15	$1018.65	3
Illinois	47	$1440.76	$1035.18	4
Ohio	45	$1325.43	$1030.06	3
Nevada	40	$892.16	$727.73	3
New Jersey	37	$1115.13	$783.46	3
South Dakota	36	$682.17	$552.08	2
Mississippi	35	$843.33	$703.08	3
Florida	29	$1526.53	$1036.46	2
Colorado	26	$1333.39	$1034.37	2
Washington	26	$1333.06	$1034.37	2
Louisiana	26	$1181.58	$1008.28	2
Connecticut	25	$1397.96	$1028.80	2
Minnesota	23	$748.64	$575.98	2
Maine	19	$1219.79	$1026.84	1
Alabama	15	$1202.34	$1035.36	1
Montana	14	$1293.11	$1018.53	1
Michigan	14	$1406.79	$1033.99	1
Kansas	13	$1152.39	$966.68	1
Delaware	12	$1308.19	$1037.63	1
Nebraska	12	$1032.44	$910.60	1
Arkansas	11	$1168.11	$1034.55	1

Related codes

44207Partial removal of large bowel and reattachment to rectum$1484.09
44213Partial release of large bowel and partial removal of large bowel$161.54

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.