CPT 43232 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 43232 |
National average reimbursement for CPT 43232 by major payers:
$331.05
$351.04
$347.59
$413.66
| 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 43232 | ||||||
United | 43232 | $2782.00 | 1750913109 - CAREOS SURGICENTER, LLC, CAREOS | 844484446 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $1258.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $477.00 | 1831109875 - M-S SURGERY CENTER LLC | 205219388 - (CA) MS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $766.00 | 1134140122 - ARTHROSCOPIC SURGERY CENTER, LLC | 392000854 - (WI) ARTHROSCOPIC SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $654.00 | 1144370594 - THIRD STREET SURGERY CENTER LLC, THIRD STREET SURGERY CENTER LP | 841663840 - (CA) THIRD STREET SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $1200.00 | 1023072824 - SOUTH JERSEY EYE PHYSICIANS, LLC, THE SURGICAL CENTER AT SOUTH JERSEY EYE PHYSICIANS, PA | 222116946 - (NJ) SOUTH JERSEY EYE PHYSICIANS, PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $732.78 | 1083838130 - PRASANNA YELAMANCHILI | 350593390 - DEACONESS HOSPITAL INC | IN | Cardiovascular Disease Physician (207RC0000X) |
United | 43232 | $985.00 | 1366065674 - SOUTH DENVER SURGICAL SERVICES LLC, SOUTH DENVER UROLOGY CENTER | 850873977 - (CO) SOUTH DENVER SURGICAL SERVICES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $535.00 | 1992018790 - REVISION ADVANCED SURGERY CENTER INC | 200734091 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $395.00 | 1588991228 - THE EYE SURGICAL CENTER OF FORT WAYNE, LLC | 271316595 - (IN) THE EYE SURGICAL CENTER OF FORT WAYNE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $947.00 | 1154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE | 871712552 - (AZ) BSC 3 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $2270.00 | 1619974219 - ST. JOSEPH'S SURGERY CENTER LP | 201019390 - (CA) ST JOSEPHS SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $1904.00 | 1053362343 - SODERSTROM DERMATOLOGY CENTER S C, PEORIA AMBULATORY SURGERY CENTER | 371001642 - (IL) SODERSTROM DERMATOLOGY CENTER, S.C. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $600.00 | 1073845087 - EYE SURGERY CENTERS OF ARIZONA, LLC, EYE SURGERY AT THE BILTMORE, LLC | 271798256 - (AZ) EYE SURGERY CENTERS OF ARIZONA 401(K) PROFIT SHARING PLAN & TRUST | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43232 | $373.00 | 1033113402 - NORTHWEST FLORIDA SURGICAL CENTER, LLC, NORTH FLORIDA SURGERY CENTER | 593081991 - (FL) NORTHWEST FLORIDA SURGICAL CENTER | FL | 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 43232 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43232 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 43232 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 |
|---|---|---|
| 43226-CPT | Moderate | Esophagoscopy Flexible Transoral; With Insertionof Guide Wire Followed By Passage Of Dilator(S) Over Guide Wire (Revised 01/01/2014) |
| 43227-CPT | Moderate | Esophagoscopy Flexible Transoral; With Control Of Bleeding Any Method (Revised 01/01/2014) |
| 43231-CPT | Moderate | Esophagoscopy Flexible Transoral; With Endoscopic Ultrasound Examination (Revised 01/01/2014) |
| 43232-CPT | Moderate | Esophagoscopy Flexible Transoral; With Transendoscopic Ultrasound-Guided Intramural Or Transmural Fine Needle Aspiration/Biopsy(S) (Revised 01/01/2014) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43232. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43232 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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