Data Platform
Sign InTry for Free

CPT 40843 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Vestibuloplasty Posterior Bil
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

11 - Office

21 - Inpatient Hospital

Common Modifiers

None

51 - Multiple procedures

59 - Distinct Procedural Service

58 - Staged or related procedure during postoperative period

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 40843

National average reimbursement for CPT 40843 by major payers:

bcbs

$1,409.52

uhc

$1,484.44

aetna

$1,580.34

cigna

$1,900.80

Preview provider-level rates for...
For billing codeCPT 40843
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 40843

United
40843$3150.001609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER752592508 - (TX) DESOTO SURGICARE PARTNERS LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$3273.001255353389 - SOMERSET AMBULATORY SURGICAL CENTER, LLC371743209NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$7169.001821614710 - BAYCARE AURORA KAUKAUNA SURGERY CENTER LLC, KAUKAUNA SURGERY CENTER851420464 - (WI) BAYCARE AURORA KAUKAUNA SURGERY CENTER LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$3008.001275071789 - KADLEC REGIONAL MEDICAL CENTER910655392 - KADLEC REGIONAL MEDICAL CENTERWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$1256.001437115094 - SURGERY CENTER OF LANCASTER, LP201824455 - (PA) SURGERY CENTER OF LANCASTER, LP.PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$2859.001215116611 - UPPER BAY SURGERY CENTER, LLC205547410 - (MD) UPPER BAY SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$1925.001770072803 - PACIFIC VASCUCARE SURGERY CENTER823288521 - (CA) PACIFIC VASCUCARE SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$1000.001164516084 - ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC113530475 - (NY) ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE, INC.NYAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$2159.001184664609 - ENDOSCOPY CENTER AT ROBINWOOD, LLC20615867 - (MD) ENDOSCOPY CENTER AT ROBINWOOD LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$2307.001891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY611917634 - (FL) ADVANCED CENTER FOR SURGERYFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$803.001427662345 - BENTONVILLE AMBULATORY SURGERY CENTER, LLC832500684 - (AR) BENTONVILLE AMBULATORY SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$1204.001003374711 - RIVERVIEW SURGICAL CENTER LLC821368525 - (NE) RIVERVIEW SURGICAL CENTER, LLCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$1990.001457670648 - THE RETINA SURGERY CENTER LLC, THE RETINA SURGERY CENTER853784941WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$1150.001275802183 - PRECISION VISION SURGERY CENTER, LLC731097247 - (OK) EDWARD D. GLINSKI, D.O. & ACCOCIATES, INC.OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
40843$2590.001962505354 - PROVIDENCE HEALTH SERVICES OF WACO, PROVIDENCE HEALTH CENTER741109636 - (TX) ASCENSION PROVIDENCETXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 40843 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 40843 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 40843 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.

CodeComplexityDescription
40830-CPTModerateRep Lac Oral Vestib < 2cm
40831-CPTModerateRep Lac Oral Vestib > 2cm/Complex
40840-CPTHighVestibuloplasty Anterior
40843-CPTHighVestibuloplasty Posterior Bil

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40843. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 40843 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 40843) and we'll show you how you compare in 15 minutes or less.