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See a sample rate comparisonCPT 43325 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.
Esophagus Surgery For Reflux, Surgery To Repair A Weakened Valve Or Muscle Between The Esophagus And The Stomach. The Procedure Relieves Acid Reflux.
| 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 | AS - PA/NP/CNS assistant at surgery 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | $1,272.91 national non-facility rate (2026) · View Medicare rates for 43325 |
| Medicaid Fee Schedule | $991.485 median of the 8 states in the free preview · View Medicaid rates for 43325 |
National average reimbursement for CPT 43325 by major payers:
$1,787.40
$1,802.51
$1,875.94
$2,152.77
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CPT 43325
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Southwest LLP, Memorial Hermann Surgery Center Southwest
Memorial Hermann Surgery Center Southwest LLP
$4,893.00Published rateAdvanced Center For Surgery, The Advanced Center For Surgery
Advanced Center For Surgery
$983.00Published rateIdaho Physical Medicine And Rehabilitation PA
Idaho Physical Medicine & Rehabilitation, PA
$670.00Published rateLake Jackson Endoscopy Center, Lp.
Lake Jackson Endoscopy Center Lp
$475.00Published rateDupage Eye Surgery Center, LLC
Dupage Eye Surgery Center LLC
$270.00Published rate
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See a sample payer proposalCPT 43325 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43325 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 43325 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 |
| 43320-CPT | High | Esophagogastrostomy (Cardiopla, Esophagogastrostomy (Cardioplasty) With Or Without Vagotomyand Pyloroplasty Transabdominal Or Transthoracic Approach |
| 43325-CPT | High | Esophagus Surgery For Reflux, Surgery To Repair A Weakened Valve Or Muscle Between The Esophagus And The Stomach. The Procedure Relieves Acid Reflux. |
| 43330-CPT | High | Surgical Repair Of Esophagus, Surgery To Repair The Esophagus Through An Incision Into Chest (Thoracic Approach) Or Abdomen. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43325 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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