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See a sample rate comparisonCPT 43286 Fee Schedule
Last Verified: October 2026
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.
Esophagectomy Total Or Near T, Esophagectomy Total Or Near Total With Laparoscopic Mobilization Of The Abdominal And Mediastinal Esophagus And Proximal Gastrectomy With Laparoscopic Pyloric Drainage Procedure If Performed With Open Cervical Pharyngogastrostomy Or Esophagogastrostomy (Ie Laparoscopic Transhiatal Esophagectomy
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 62 - Co-Surgeons GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $2,945.29 national non-facility rate (2026) · View Medicare rates for 43286 |
| Medicaid Fee Schedule | $2,281.305 median of the 8 states in the free preview · View Medicaid rates for 43286 |
National average reimbursement for CPT 43286 by major payers:
$4,193.83
$4,391.84
$4,337.40
$5,061.81
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CPT 43286
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center, Memorial Hermann Surgery Center, The Woodlands
Memorial Hermann Surgery Center
$5,554.00Published rateSummit Ambulatory Surgical Center, LLC
$1,064.00Published rateVivere Health Dallas, LLC, Vivere-Dallas Surgery Center
Vivere Health Dallas LLC
$736.00Published rateAmin Surgery Center For Women LLC
$592.00Published rateZion Ambulatory Center LLC
$48.00Published rate
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See a sample payer proposalCPT 43286 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43286 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 43286 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 |
|---|---|---|
| 43286-CPT | High | Esophagectomy Total Or Near T, Esophagectomy Total Or Near Total With Laparoscopic Mobilization Of The Abdominal And Mediastinal Esophagus And Proximal Gastrectomy With Laparoscopic Pyloric Drainage Procedure If Performed With Open Cervical Pharyngogastrostomy Or Esophagogastrostomy (Ie Laparoscopic Transhiatal Esophagectomy |
| 43287-CPT | High | Esphg Dstl 2 3 W Laps Moblj, Esophagectomy Distal Two Thirds With Laparoscopic Mobilization Of The Abdominal And Lower Mediastinal Esophagus And Proximal Gastrectomy With Laparoscopic Pyloric Drainage Procedure If Performed With Separate Thoracoscopic Mobilization Of The Middle And Upper Mediastinal Esophagus And Thoracic Esophagogastrostomy Ie Laparoscopic Thoracoscopic Esophagectomy Ivor Lewis Esophagectomy |
| 43288-CPT | High | Esophagectomy Total Or Near Total With Thoracoscopic Mobilization Of The Upper Middle And Lower Mediastinal Esophagus With Separate Laparoscopic Proximal Gastrectomy With Laparoscopic Pyloric Drainage Procedure If Performed With Open Cervical Pharyngogastrostomy Or Esophagogastrostomy (Ie Thoracoscopic Laparoscopic And Cervical Incision Esophagectomy Mckeown Esophagectomy Tri-Incisional Esophagectomy) |
| 43289-CPT | High | Esophagus Procedure With Scope, Esophagus Procedure Using A Scope (Laparoscope). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43286. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43286 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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