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See a sample rate comparisonCPT 43227 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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 | None XS - Separate Structure 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 43227 |
| Medicaid Fee Schedule | View Medicaid rates for 43227 |
National average reimbursement for CPT 43227 by major payers:
$558.09
$638.86
$741.89
$884.80
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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 CPT 43227 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 43227 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 |
|---|---|---|
| 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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