CPT 43287 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 62 - Co-Surgeons • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| CMS | $3,405.76 Physician Fee Schedule |
National average reimbursement for CPT 43287 by major payers:
$4,531.80
$4,989.88
$4,995.27
$5,849.69
| 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 43287 | ||||||
United | 43287 | $806.00 | 1376542076 - FREDERICK SURGICAL CENTER, LLC | 521652443 - (MD) FREDERICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $510.00 | 1770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA | 264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $700.00 | 1962903831 - CLIFTON PARK ASC LLC, ORTHONY SURGICAL SUITES | 814670264 - (NY) CLIFTON PARK ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $601.00 | 1912675513 - SUNRISE SURGERY CENTER LLC | 824678882 - (NY) SUNRISE SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $955.00 | 1538664339 - FOLSOM ENDOSCOPY CENTER LLC, FOLSOM SIERRA ENDOSCOPY CENTER | 824882599 - (CA) FOLSOM ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $1912.00 | 1730563610 - SACRAMENTO MIDTOWN ENDOSCOPY CENTER, LLC | 364811322 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $1336.00 | 1508851213 - FROEDTERT SURGERY CENTER, LLC | 201499345 - (WI) FROEDTERT SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $650.00 | 1659451078 - ACADEMY ORTHOPEDICS, LLC, DBA ACADEMY ORTHOPEDICS, LLC, AMBULATORY SURGICAL CENTER | 582383939 - (GA) ACADEMY ORTHOPEDICS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $555.00 | 1972030161 - ADVANCED VISION SURGERY CENTER LLC | 820697854 - (CO) ADVANCED VISION SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $1873.00 | 1386028439 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL SURGERY CENTER | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $1028.00 | 1891148219 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $925.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $773.00 | 1366643751 - SPECIALTY SURGICAL CENTER OF THOUSAND OAKS, L.P. | 205991988 - (CA) SPECIALTY SURGICAL CENTER OF THOUSAND OAKS, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $980.00 | 1205845740 - THE UROLOGY CENTER LLC | 311579733 - (OH) THE UROLOGY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43287 | $1028.00 | 1104907328 - ANDREWS INSTITUTE ASC LLC | 352274952 - (FL) ANDREWS INSTITUTE ASC, LLC | FL | 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 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 |
|---|---|---|
| 43200-CPT | Moderate | Esophagoscopy Flexible Transoral; Diagnostic Including Collection Of Specimen(S) By Brushing Orwashing When Performed (Separate Procedure) (Revised 01/01/2014) |
| 43286-CPT | High | 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 | 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) |
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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