CPT 43327 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 |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 51 - Multiple procedures |
| Complexity Level | High |
| CMS | $815.78 Physician Fee Schedule |
National average reimbursement for CPT 43327 by major payers:
$1,089.78
$1,149.27
$1,155.91
$1,384.76
| 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 43327 | ||||||
United | 43327 | $583.00 | 1023010311 - BLUE RIDGE SURGICAL CENTER, LLC | 141854493 - (MO) BLUE RIDGE SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $183.00 | 1679566228 - AMBULATORY FOOT AND ANKLE CENTER, INC. | 521910756 - (MD) AMBULATORY FOOT AND ANKLE CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $469.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $1275.00 | 1477519130 - SURGICARE OF MINNEAPOLIS LTD, SURGICAL SPECIALTY CENTER OF MINNESOTA | 411624905 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $1036.00 | 1962893354 - WESTMORELAND ASC, LLC, APEX SURGICAL CENTER | 462808005 - (NY) WESTMORELAND ASC, LLC DBA APEX | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $1028.00 | 1629075106 - MICHIGAN ENDOSCOPY CENTER LLC | 364469630 - (MI) MICHIGAN ENDOSCOPY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $1955.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $259.00 | 1548582463 - CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER, LLC, NONE | 271867311 - (VA) CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $275.00 | 1770907172 - EYE AND LASER SURGERY CENTERS OF NEW JERSEY LLC | 462875016 - (NJ) EYE AND LASER SURGERY CENTERS OF NEW JERSEY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $481.00 | 1063715951 - NEW BRITAIN SURGERY CENTER LLC | 273829147 - (PA) NEW BRITAIN SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $934.00 | 1811978356 - WESTSIDE SURGERY CENTER, LLC | 900082030 - (OR) WESTSIDE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $344.00 | 1093895757 - PATRICK D REEVES MDPA, WILSON SURGICENTER | 412062384 - (TX) PATRICK D. REEVES, M.D., P.A. | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $1424.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $107.00 | 1992794580 - VALLEY MEDICAL PLAZA AMBULATORY | 731718858 - (CA) VALLEY MEDICAL PLAZA AMBULATORY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43327 | $150.00 | 1053510933 - MONTGOMERY EYE SURGERY CENTER LLC, MONTGOMERY EYE SURGERY CENTER | 621607284 - (AL) MONTGOMERY EYE SURGERY CENTER LLC | AL | 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 43327 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43327 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 43327 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 |
|---|---|---|
| 43325-CPT | High | Esophagogastric Fundoplas W Fundic Patch |
| 43327-CPT | High | Once Per Dos Esophagogastric Fundoplasty Partial Or Complete; Laparotomy |
| 43328-CPT | High | Once Per Dos Esophagogastric Fundoplasty Partial Or Complete; Thoracotomy |
| 43330-CPT | High | Esophagomyotomy W W/O Hernia Repair; Abd |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43327. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43327 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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