How much does Medicare pay for CPT 44500?

Medicare allowed an average of $16.20 per service and paid $12.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $95.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 44500?

Dilation of stomach and/or small bowel using long gastrointestinal tube. It was billed 1,062 times to 1,010 Medicare beneficiaries by 52 providers in 2024.

Which specialty bills 44500 most?

Physician Assistant, with 474 services from 22 clinicians. Next are Diagnostic Radiology, Nurse Practitioner.

CPT 44500

Dilation of stomach and/or small bowel using long gastrointestinal tube

$16.20Medicare-allowed amount per service, averaged across 1,062 services

Providers submitted

$95.44

Asking price, not received

Medicare allowed

$16.20

The fee schedule figure

Medicare paid

$12.78

Balance is patient coinsurance

Providers submitted an average of $95.44 for this code and Medicare allowed $16.20 — 5.9× 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 $12.78 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,062
Beneficiaries: 1,010
Providers billing it: 52
Total allowed: $17,204

What Medicare pays for CPT 44500

Across 1,062 services billed by 52 providers to 1,010 beneficiaries, Medicare allowed an average of $16.20 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 44500

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physician Assistant	474	454	$15.26	22
Diagnostic Radiology	310	294	$18.32	20
Nurse Practitioner	278	262	$15.44	10

44500 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
Utah	409	$15.05	$12.22	19
Michigan	199	$16.12	$12.26	6
Indiana	94	$15.35	$12.95	3
Florida	92	$18.55	$13.77	6
Illinois	69	$18.38	$14.60	5
Virginia	63	$17.95	$14.59	3
North Carolina	41	$15.34	$12.35	3
Connecticut	31	$17.18	$13.51	2
Minnesota	15	$19.91	$14.59	1
Kansas	13	$16.55	$14.60	1
Colorado	13	$18.50	$14.55	1
Washington	12	$17.93	$14.58	1
Tennessee	11	$14.68	$12.40	1

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.