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See a sample rate comparisonCPT 43045 Fee Schedule
Last Verified: October 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.
Esophagotomy Thoracic Approac, Esophagotomy Thoracic Approach With Removal Of Foreignbody Esophagotomy Thoracic Approach With Removal Of Foreign
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | 51 - Multiple procedures 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $1,258.55 national non-facility rate (2026) · View Medicare rates for 43045 |
| Medicaid Fee Schedule | $985.84 median of the 8 states in the free preview · View Medicaid rates for 43045 |
National average reimbursement for CPT 43045 by major payers:
$1,615.68
$1,760.62
$1,793.28
$2,132.79
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CPT 43045
5 of 25 sample ratesHigher to lower in this preview
Monterey Peninsula Surgery Center Munras Ave
Monterey Peninsula Surgery Center, LLC
$6,158.00Published rateSummit Ambulatory Surgical Center, LLC
$1,064.00Published rateMountain West Surgical Center, LLC
Mountain West Surgical Center LLC
$775.00Published rateCrescent View Surgery Center, LLC
$457.00Published rateDigestive Health Complex
$200.00Published rate
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See a sample payer proposalCPT 43045 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43045 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 43045 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 |
|---|---|---|
| 43020-CPT | Moderate | Esophagotomy Cervical Approac, Esophagotomy Cervical Approach With Removal Of Foreignbody Esophagotomy Cervical Approach With Removal Of Foreign |
| 43030-CPT | Moderate | Myotomy Cricopharyngeal |
| 43045-CPT | High | Esophagotomy Thoracic Approac, Esophagotomy Thoracic Approach With Removal Of Foreignbody Esophagotomy Thoracic Approach With Removal Of Foreign |
| 43100-CPT | Moderate | Xcision Of Lesion Esophag W/ Primar Rpair; Cervcal Approa, Excision Of Lesion Esophagus With Primary Repair; Cervical Approach |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43045. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43045 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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