Monday, July 26, 2010

Medicare payment for CPT 44388,44389,44390,44380 - 44383

2010 Medicare GI Endoscopy Procedure Reimbursement Guide for STOMA (COLON) & (ILEUM)



STOMA (COLON) Ambulatory
Surgery Center
Outpatient
Hospital
Physician
Services
Code Procedure Description ASC Facility Fee
(National Medicare Avg)
APC Facility Fee
Schedule
(National Medicare Avg)²
Fee When
Procedure
Performed in
Hospital or ASC
(National Medicare Avg)³
Fee When
Procedure
Performed
in Office
(National Medicare Avg)³
44388  Colonoscopy through stoma; diagnostic, with or without collection of specimen(s) by  brushing or washing (separate procedure)    $353.21    0143    $613.74    $163.82    $325.84  
44389  …with biopsy, single or multiple    $353.21    0143    $613.74    $182.23    $374.56  
44390  …with removal of foreign body    $353.21    0143    $613.74    $219.03    $434.10  
44391  …with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)      $353.21    0143    $613.74    $248.98    $481.73  
44392  …with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery    $353.21    0143    $613.74    $216.51    $410.28  
44393  …with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy  forceps, bipolar cautery or snare technique      $353.21    0143    $613.74    $274.60    $475.60  
44394  …with removal of tumor(s), polyp(s), or other lesion(s) by snare technique    $353.21    0143    $613.74    $253.67    $475.96  
44397  …with transendoscopic stent placement (includes predilation)    $875.58    0384    $1,785.67    $272.08    NA*  














STOMA (ILEUM)


44380 Ileoscopy, through stoma; diagnostic, with or
without collection of specimen(s) by brushing
or washing (separate procedure)
 $375.60    0142    $663.97    $67.84    NA*  
44382 …with biopsy, single or multiple  $375.60    0142    $663.97    $81.19    NA*  
44383 …with transendoscopic stent placement
(includes predilation)
 $1.116.19    0384    $1,785.67    $170.68    NA*  

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