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See a sample rate comparisonCPT 43244 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.
Exam Of Digestive Tract, Exam Using A Scope (Endoscope) To View The Esophagus Stomach And Part Of The Intestines. Enlarged Veins (Varices) In The Esophagus And Stomach Are Treated At This Time.
| 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 AG - Primary physician 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 43244 |
| Medicaid Fee Schedule | View Medicaid rates for 43244 |
National average reimbursement for CPT 43244 by major payers:
$328.56
$353.36
$377.23
$417.01
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CPT 43244
5 of 25 sample ratesHigher to lower in this preview
Northern Virginia Surgery Center LLC
$2,137.00Published rateLindenhurst Surgery Center LLC, Red Oaks Surgical Suites
Lindenhurst Surgery Center LLC
$1,300.00Published rateInterventional Spine And Pain Management Ambulatory Surgical Center, Ispm Asc
Interventional Spine And Pain Management Ambulatory Surgical Center
$800.00Published rateSnks Enterprises LLC, Sol Valley Surgery Center
Snks Enterprises LLC
$575.00Published rateThe Kissimmee Fl Endoscopy Asc LLC, Kissimmee Endoscopy Center
$390.00Published rate
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See a sample payer proposalCPT 43244 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43244 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 43244 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 |
|---|---|---|
| 43241-CPT | Moderate | Upper Gastrointestinal Endosco, Upper Gastrointestinal Endoscopy Including Esophagusstomach And Either The Duodenum Andor Jejunumas Appropriate With Transendoscopic Tube Or Cat Heter Placement |
| 43242-CPT | Moderate | Endoscopic Procedure, Upper Gastrointestinal Endoscopy Including Esophagus Stomach And Either The Duodenum And/Or Jejunum As Appropriate; With Transendoscopic Ultrasound-Guided Intramural Or Transmural Fine Needle Aspiration/Biopsy(S)(Includes Endoscopic Ultrasound Examination Of The Esophagus Stomach And Either The Duodenum And/Or Jejunum As Appropriate) |
| 43243-CPT | Moderate | Exam Of Digestive Tract, Exam Using A Scope (Endoscope) To View The Esophagus Stomach And Part Of The Intestines. Enlarged Veins (Varices) In The Esophagus And Stomach Are Treated At This Time. |
| 43244-CPT | Moderate | Exam Of Digestive Tract, Exam Using A Scope (Endoscope) To View The Esophagus Stomach And Part Of The Intestines. Enlarged Veins (Varices) In The Esophagus And Stomach Are Treated At This Time. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43244. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43244 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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