Rate Benchmarking
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Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHealthcare 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 62 - Co-Surgeons AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $3,294.00 national non-facility rate (2026) · View Medicare rates for 43287 |
| Medicaid Fee Schedule | $2,550.645 median of the 8 states in the free preview · View Medicaid rates for 43287 |
National average reimbursement for CPT 43287 by major payers:

$4,531.80

$4,989.88

$4,995.27

$5,690.87
Choose a payer to see a sample of rates for CPT 43287.
Geneva Surgical Suites, LLC
Winter Haven Ambulatory Surgical Center LLC
Winter Haven Ambulatory Surgical Center, LLC
New England Baptist Surgery Center LLC
Surgcenter At National Harbor, LLC, Harborside Surgery Center
Harborside Surgery Center
New Jersey Interventional Associates LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 43287 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43287 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 43287 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 43287. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43287 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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