Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 43123 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.
Partial Removal Of Esophagus, Partial Esophagectomy Thoracoabdominal Or Abdominal Approach With Or Without Proximal Gastrectomy With Colon Interposition Or Small Intestine Reconstruction Including Intestine Mobilization Preparation And Anastomosis Es
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 19 - Off Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 62 - Co-Surgeons 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | $4,175.45 national non-facility rate (2026) · View Medicare rates for 43123 |
| Medicaid Fee Schedule | $3,228.09 median of the 8 states in the free preview · View Medicaid rates for 43123 |
National average reimbursement for CPT 43123 by major payers:
$5,529.97
$5,819.45
$6,165.93
$7,061.83
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 43123.
CPT 43123
5 of 25 sample ratesHigher to lower in this preview
Thr/Stt Southlake Asc, LLC
$6,068.00Published rateCei Physicians Psc LLC, Cvp Surgery Center
Cincinnati Eye Institute
$1,262.00Published rateArusha LLC, The Surgery Center Of Chester County
Arusha LLC
$975.00Published rateSt George Endoscopy Center LLC, St. George Endoscopy Center
St George Endoscopy Center LLC
$624.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$63.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 43123 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43123 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 43123 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 |
|---|---|---|
| 43118-CPT | High | Partial Removal Of Esophagus, Partial Esophagectomy Distal Two Thirds With Thoracotomy And Separate Abdominal Incision With Or Without Proximal Gastrectomy With Colon Interposition Or Small Intestine Reconstruction Including Intestine Mobilization Preparation And Anastomosis Es |
| 43121-CPT | High | Partial Removal Of Esophagus, Partial Esophagectomy Distal Two Thirds With Thoracotomy Only With Or Without Proximal Gastrectomy With Thoracic Esophagogastrostomy With Or Without Pyloroplasty |
| 43122-CPT | High | Partial Removal Of Esophagus, Partial Esophagectomy Thoracoabdominal Or Abdominal Approach With Or Without Proximal Gastrectomy With Esophagogastrostomy With Or Without Pyloroplasty |
| 43123-CPT | High | Partial Removal Of Esophagus, Partial Esophagectomy Thoracoabdominal Or Abdominal Approach With Or Without Proximal Gastrectomy 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 43123. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43123 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 43123) and we'll show you how you compare in 15 minutes or less.