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See a sample rate comparisonCPT 43227 Fee Schedule
Medicare rates as of October 2026
CPT 43227 is classified under Surgery, in the Surgical Procedures on the Digestive System subgroup.
Control Bleeding In Esophagus, Exam Of The Esophagus Using A Scope (Endoscope). The Procedure Includes Control Of Bleeding In The Esophagus.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | XS - Separate Structure 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $655.33 national non-facility rate (2026) · View Medicare rates for 43227 |
| Medicaid Fee Schedule | $513.27 median of the 8 states in the free preview · View Medicaid rates for 43227 |
National average reimbursement for CPT 43227 by major payers:
$558.09
BCBS / Anthem
$638.86
UnitedHealthcare
$741.89
Aetna
$884.80
Cigna
Compare published rates across providers.
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CPT 43227
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Kirby, LLC, Memorial Hermann Surgery Center Kirby Glen
$2,480.00Published rateSurgery Center Of Pembroke Pines, LLC
Surgery Center Of Pembroke
$1,258.00Published rate90210 Surgery Medical Center, LLC, 90210 Surgery Medical Center At Linden
90210 Surgery Medical Center
$830.00Published rateGainesville Urology Asc LLC
$610.00Published rateBox Hill Surgery Center LLC
$375.00Published rate
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See a sample payer proposalCPT 43227 vs. Other Surgical Procedures on the Digestive System Codes
The table lists codes related to 43227. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 43220-CPT | Moderate | Esophagus Enlargement, Exam Of The Esophagus Aided By A Scope (Endoscope). The Procedure Inserts A Balloon That Is Inflated In Order To Enlarge Or Open Up The Esophagus. |
| 43227-CPT | Moderate | Control Bleeding In Esophagus, Exam Of The Esophagus Using A Scope (Endoscope). The Procedure Includes Control Of Bleeding In The Esophagus. |
| 43229-CPT | Moderate | Esophagoscopy Lesion Ablate, Esophagoscopy Flexible Transoral With Ablation Of Tumor S Polyp S Or Other Lesion S Includes Pre And Post Dilation And Guide Wire Passage When Performed |
| 43231-CPT | Moderate | Esophagoscopy Rigid Or Flexib, Esophagoscopy Rigid Or Flexible Diagnostic With Or Without Collection Of Specimens By Brushing Or Washing (Separate Procedure) With Endoscopic Ultrasound Examination. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43227. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43227 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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