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See a sample rate comparisonCPT 43328 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 |
| Common Modifiers | GC - Service performed by resident under supervision 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $1,061.15 national non-facility rate (2026) · View Medicare rates for 43328 |
| Medicaid Fee Schedule | $822.535 median of the 8 states in the free preview · View Medicaid rates for 43328 |
National average reimbursement for CPT 43328 by major payers:
$1,488.04
$1,611.42
$1,563.13
$1,901.66
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CPT 43328
5 of 25 sample ratesHigher to lower in this preview
Carris Health LLC, Centracare Willmar Surgery Center
Carris Health LLC
$3,418.00Published rateFountain Valley Surgery Center, LLC
$1,121.00Published rateCypress Ambulatory Surgery Center, LLC, Wellness Avenue Surgery Center
$900.00Published rateLapeer County Surgery Center LLC
Lapeer County Surgery Center L
$494.00Published rateNorth River Surgical Center, LLC, North River Surgical Center, Inc.
$110.00Published rate
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See a sample payer proposalCPT 43328 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43328 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 43328 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 | Esophagus Surgery For Reflux, Surgery To Repair A Weakened Valve Or Muscle Between The Esophagus And The Stomach. The Procedure Relieves Acid Reflux. |
| 43327-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. |
| 43328-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 43328. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43328 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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