CPT 43244 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 • AG - Primary physician • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $233.87 Physician Fee Schedule |
National average reimbursement for CPT 43244 by major payers:
$328.56
$353.36
$377.23
$425.38
| 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 43244 | ||||||
United | 43244 | $720.00 | 1235241688 - SAN ANTONIO ASC L.P., SPECIALTY SURGERY CENTER | 742863505 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $360.00 | 1013011162 - BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | 593213374 - (FL) BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $512.00 | 1396203238 - SUN CITY CENTER AMBULATORY SURGERY CENTER, LLC, SUN CITY ASC | 832043435 - (FL) SUN CITY CENTER AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $1022.00 | 1457968430 - PARK VENTURA ENDOSCOPY CENTER, LLC, DIGESTIVE HEALTH CENTER OF ALLEN | 412059014 - (TX) PARK VENTURA ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $531.00 | 1629166624 - AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC | 861081788 - (NV) AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $800.00 | 1982965612 - SKYPARK SURGERY CENTER LLC | 455320930 - (CA) SKYPARK SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $1045.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 881346867 - (RI) CROSSINGS SURGERY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $1657.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $464.00 | 1619124401 - CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC | 562059693 - (NC) CHARLOTTE GASTROENTEROLOGY & HEPATOLOGY, PLLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $1313.00 | 1578146429 - BSMH AMBULATORY VENTURES II LLC, MERCY HEALTH CANFIELD SURGERY CENTER | 863462441 - (OH) BSMH AMBULATORY VENTURES II LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $800.00 | 1750420147 - INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER, ISPM ASC | 205896580 - (GA) INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $800.00 | 1598372963 - ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC | 853147678 - (GA) ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $555.00 | 1609568922 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $527.00 | 1043222417 - COTTONWOOD DAY SURGERY CENTER | 860757762 - (AZ) COTTONWOOD DAY SURGERY CENTER, INC. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43244 | $443.27 | 1659351419 - JASON MECKLER | 350593390 - DEACONESS HOSPITAL INC | IN | Neurology Physician (2084N0400X) |
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 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 | Esophagogastroduodenoscopy Flexible Transoral; With Insertion Of Intraluminal Tube Or Catheter (Revised 01/01/2014) |
| 43242-CPT | Moderate | Esophagogastroduodenoscopy Flexible Transoral; With Transendoscopic Ultrasound-Guided Intramural Or Transmural Fine Needle Aspiration/Biopsy(S) (Includes Endoscopic Ultrasound Examination Of Theesophagus Stomach And Either The Duodenum Or A Surgically Altered Stomach Where The Jejunum Is Examined Distal To The Anastomosis) (Revised 01/01/2014) |
| 43243-CPT | Moderate | Esophagogastroduodenoscopy Flexible Transoral; With Injection Sclerosis Of Esophageal/Gastric Varices (Revised 01/01/2014) |
| 43244-CPT | Moderate | Esophagogastroduodenoscopy Flexible Transoral; With Band Ligation Of Esophageal/Gastric Varices (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 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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