CPT 43332 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 • 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 43332 |
National average reimbursement for CPT 43332 by major payers:
$1,460.35
$1,629.59
$1,656.77
$1,944.79
| 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 43332 | ||||||
United | 43332 | $983.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 10735856 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $585.00 | 1255875126 - VIP SURG ASC, LLC, VIP SURGICAL CENTER | 811621842 - (TX) VIP SURG ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $1670.00 | 1629664156 - OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER, OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER NEW ALBANY | 854149946 - (OH) OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $450.00 | 1710420120 - AMERICAN ACCESS CARE OF MIAMI ASC LLC, AZURA SURGERY CENTER MIAMI | 814118495 - (FL) AMERICAN ACCESS CARE OF MIAMI ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $475.00 | 1831283860 - THE COOKEVILLE SURGERY CENTER | 621366678 - (TN) THE COOKEVILLE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $604.00 | 1215302906 - RADIUS SURGERY CENTER LLC | 474627643 - (GA) RADIUS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $654.00 | 1558390781 - BAPTIST-PHYSICIANS SURGERY CENTER | 43665929 - (KY) BAPTIST-PHYSICIANS SURGERY CENT | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $1000.00 | 1578073631 - IREDELL PHYSICIAN NETWORK LLC, IREDELL AMBULATORY SURGERY CENTER | 263853529 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $296.00 | 1710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER | 521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $5213.00 | 1528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC | 201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $400.00 | 1871598300 - NOVAMED SURGERY CENTER OF COLUMBUS, LLC | 50540724 - (GA) NOVAMED SURGERY CENTER OF COLUMBUS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $1167.00 | 1871032680 - OLIVE AMBULATORY SURGERY CENTER, LLC, NORTH CAMPUS SURGERY CENTER | 203834012 - (MO) OLIVE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $2544.00 | 1568094399 - SURGERY CENTER OF SOUTHWEST OHIO, LLC, THE SURGERY CENTER OF SOUTHWEST OHIO | 831673860 - (OH) THE SURGERY CENTER OF SOUTHWEST | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $200.00 | 1831182799 - ZION EYE INSTITUTE, INC | 841432944 - (UT) ZION EYE INSTITUTE INC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $112.00 | 1760598577 - ACUTE & CHRONIC PAIN MANAGEMENT CENTER PA, ACUTE & CHRONIC PAIN AND SPINE CENTER | 752711926 - (TX) ACUTE AND CHRONIC PAIN AND SPINE CENTER | TX | 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 43332 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43332 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 43332 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 |
|---|---|---|
| 43282-CPT | High | Laps Rpr Paraesphgl Hrna Incl Fundplsty W Mesh |
| 43327-CPT | High | Once Per Dos Esophagogastric Fundoplasty Partial Or Complete; Laparotomy |
| 43328-CPT | High | Once Per Dos Esophagogastric Fundoplasty Partial Or Complete; Thoracotomy |
| 43332-CPT | High | Once Per Dos Repair, Paraesophageal Hiatal Hernia (Including Fundoplication), Via Laparotomy, Except Neonatal; Without Implantation Of Mesh Or Other Prosthesis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43332. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43332 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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