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See a sample rate comparisonCPT 43300 Fee Schedule
Last Verified: October 2026
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.
Esophagoplasty (Plastic Repai, Esophagoplasty (Plastic Repair Or Reconstruction) Cervicalapproach Without Repair Of Tracheoesophageal Fistula
| 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 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $551.78 national non-facility rate (2026) · View Medicare rates for 43300 |
| Medicaid Fee Schedule | $473.465 median of the 8 states in the free preview · View Medicaid rates for 43300 |
National average reimbursement for CPT 43300 by major payers:
$755.77
$835.43
$875.19
$1,030.22
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CPT 43300
5 of 25 sample ratesHigher to lower in this preview
Rocky Mountain Surgery Center LLC
Rocky Mountain Surgery Center, LLC
$2,785.00Published rateBaptist Medical Park Surgery Center LLC
$1,088.00Published rateThe Regents Of The University Of California
$995.00Published rateNs Surgical Center LLC
$570.00Published rateAsc Development Company LLC
$63.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 43300 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43300 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 43300 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 |
|---|---|---|
| 43300-CPT | Moderate | Esophagoplasty (Plastic Repai, Esophagoplasty (Plastic Repair Or Reconstruction) Cervicalapproach Without Repair Of Tracheoesophageal Fistula |
| 43305-CPT | High | Repair Esophagus And Fistula, Esophagoplasty Plastic Repair Or Reconstruction Cervical Approach With Repair Of Tracheoesophageal Fistula |
| 43310-CPT | High | Esophagoplasty (Plastic Repai, Esophagoplasty (Plastic Repair Or Reconstruction) Thoracicapproach Without Repair Of Tracheoesophageal Fistula |
| 43313-CPT | High | Esophagoplasty Congenital, Esophagoplasty For Congenital Defect Plastic Repair Or Reconstruction Thoracic Approach Without Repair Of Congenital Tracheoesophageal Fistula |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43300. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43300 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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