CPT 43282 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • AS - PA/NP/CNS assistant at surgery • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 43282 |
National average reimbursement for CPT 43282 by major payers:
$2,164.96
$2,395.18
$2,510.06
$2,880.65
| 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 43282 | ||||||
United | 43282 | $2698.00 | 1669540118 - STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC, VALLEY LASER SURGERY CENTER, INC. | 203111961 - (CA) STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $3045.00 | 1588756621 - HIGHLINE SOUTH AMBULATORY SURGERY CENTER, LLC, HIGHLINE SOUTH AMBULATORY SURGERY CENTER | 205001199 - (CO) HIGHLINE SOUTH AMBULATORY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $5302.00 | 1902895675 - CAROMONT HEALTH SERVICES, INC., CAROMONT SPECIALTY SURGERY | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $1111.00 | 1396738936 - WARREN GASTRO ENDOSCOPY CTR INC | 341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $4327.00 | 1831274208 - MT KISCO SURGERY CENTER LLC, THE AMBULATORY SURGERY CENTER OF WESTCHESTER | 134158313 - (NY) MOUNT KISCO SURGERY CENTER, L.L.C. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $9476.00 | 1063427557 - CAMPUS SURGERY CENTER LLC | 134334643 - (CA) CAMPUS SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $1582.00 | 1427028919 - CASCADE ENDOSCOPY CENTER, LLC, CASCADE ENDOSCOPY CENTER | 931331197 - (OR) CASCADE ENDOSCOPY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $10360.00 | 1609051515 - INDIANA ENDOSCOPY CENTERS LLC, INDIANA ENDOSCOPY CENTER | 208398421 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $7888.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $6492.00 | 1093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $7200.00 | 1003847500 - WESTSIDE OUTPATIENT CENTER, LLC, PALMS WELLINGTON SURGICAL CENTER | 651078372 - (FL) WESTSIDE OUTPATIENT CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $1925.00 | 1679737043 - FRIENDSHIP SURGERY CENTER | 261779956 - (GA) FRIENDSHIP SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $3040.00 | 1538166053 - SOUTHERN OB GYN AMBULATORY SURGERY CENTER, INC | 300070376 - (GA) SOUTHERN OB GYN AMBULATORY SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $3843.00 | 1376607309 - EMERALD SURGICAL CENTER LLC | 820485376 - (ID) EMERALD SURGICAL CENTER, L.L.C. | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43282 | $6365.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | 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 43282 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43282 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 43282 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 |
|---|---|---|
| 43279-CPT | High | Laparoscopy, Surgical, Esophagomyotomy (Heller Type), With Fundoplasty, When Performed |
| 43280-CPT | High | Laparoscopy, Surgical; Esophogogastric Fundoplasty |
| 43281-CPT | High | Laparoscopy, Surgical, Repair Of Paraesophageal Hernia, Includes Fundoplasty, When Performed; Without Implantation Of Mesh |
| 43282-CPT | High | Laps Rpr Paraesphgl Hrna Incl Fundplsty W Mesh |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43282. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43282 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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