CPT 43108 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 21 - Inpatient Hospital |
| Common Modifiers | • None • 62 - Co-Surgeons • GC - Service performed by resident under supervision |
| Complexity Level | High |
| CMS | $4,237.07 Physician Fee Schedule |
National average reimbursement for CPT 43108 by major payers:
$5,411.64
$5,749.71
$6,068.28
$6,971.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 43108 | ||||||
United | 43108 | $2785.00 | 1447364682 - RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $416.00 | 1306938550 - WEST GEORGIA ENDOSCOPY CENTER | 753182533 - (GA) WEST GEORGIA ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $587.00 | 1699817346 - CASCADE EYE & SKIN CENTERS PC, CASCADE LASER & SURGERY CENTER | 911525215 - (WA) CASCADE EYE AND SKIN CENTERS, P.C. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $2044.00 | 1861825986 - VADNAIS HEIGHTS SURGERY CENTER LLC, VADNAIS HEIGHTS SURGERY CENTER | 371866891 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $900.00 | 1346773421 - WOMEN'S CARE FLORIDA LLC, WOMEN'S CARE FLORIDA SURGICAL CENTER | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $1019.00 | 1346207875 - GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | 364053840 - (NC) GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $1231.00 | 1386748440 - COAST CENTER FOR ORTHOPEDIC AND ARTHROSCOPIC SURGERY LLC, SHARP SAN DIEGO SURGERY CENTER | 330839637 - (CA) COAST CENTER FOR ORTHOPEDIC AND ARTHROSCOPIC SURGERY, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $1274.00 | 1538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE | 833008593 - (FL) ASC OF TRINITY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $1274.00 | 1205195716 - ADVANCED ENDOSCOPY AND PAIN CENTER LLC | 454651695 - (CA) ADVANCED ENDOSCOPY AND PAIN CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $112.00 | 1093723900 - CARTER REAL ESTATE PROPERTIES INC, NORTH DALLAS SURGICARE | 752521630 - (TX) CARTER REAL ESTATE PROPERTIES INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $200.00 | 1215489182 - CORONADO SURGERY CENTER LLC | 814244748 - (AZ) CORONADO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $643.00 | 1306274097 - INTERVENTIONAL PAIN MANAGEMENT LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $988.00 | 1942267893 - GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, PA | 223345724 - (NJ) GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $1064.00 | 1962714154 - SURGCENTER OF WHITE MARSH, LLC | 272873637 - (MD) SURGCENTER OF WHITE MARSH, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43108 | $10364.00 | 1588618557 - COLUMBIA MEDICAL CENTER OF PLANO SUBSIDIARY LP, MEDICAL CITY PLANO | 621682203 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 43108 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43108 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 43108 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 |
|---|---|---|
| 43107-CPT | High | Total Or Near Total Esophagectomy, Without Thoracotomy; With Pharyngogastrostomy Or Cervical Esophagogastrostomy, With Or Without Pyloroplasty (Transhiatal) (Revision 2011) |
| 43108-CPT | High | Total Or Near Total Esophagectomy, Without Thoracotomy; With Colon Interposition Or Small Intestine Reconstruction, Including Intestine Mobilization, Preparation And Anastomosis(Es) |
| 43112-CPT | High | Total Or Near Total Esophagectomy With Thoracotomy; With Pharyngogastrostomy Or Cervical Esophagogastrostomy With Or Without Pyloroplasty (Ie Mckeown Esophagectomy Or Tri-Incisional Esophagectomy) (Desc Revised 1/1/2018) |
| 43113-CPT | High | Total Or Near Total Esophagectomy, With Thoracotomy; With Colon Interposition Or Small Intestine Reconstruction, Including Intestine Mobilization, Preparation, And Anastomosis(Es) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43108. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43108 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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