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 |
| CMS | $1,114.66 Physician Fee Schedule |
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 | $110.00 | 1083060107 - LASER SURGERY HOLDING COMPANY, LTD | 550882748 - (AZ) LASER SURGERY HOLDING COMPANY LT | AZ | 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 | $687.00 | 1114922192 - GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER, LLC | 680380691 - (CA) GASTROENTEROLOGY ASSOC. ENDOSCOPY CENTER, LLC. DBA REDDING ENDOSCOPY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $410.00 | 1740561018 - CHILDREN 1ST GRAND PRAIRIE, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 453126800 - (TX) FIDUCIARY WISE, LLC FBO CHILDREN 1ST DENTAL & SURGERY CENTER | TX | 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 | $452.00 | 1932390234 - RENO ORTHOPAEDIC SURGERY CENTER LLC | 208256389 - (NV) RENO ORTHOPAEDIC SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $565.00 | 1053560896 - ASC DEVELOPMENT COMPANY, LLC, NATIONAL SPINE AND PAIN CENTERS | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $983.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 10735856 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $335.00 | 1336100189 - ST MICHAELS SURGERY CENTER INC. | 593748609 - (FL) ST MICHAELS SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $667.00 | 1114990231 - SURGERY CENTER OF MIDDLE TENNESSEE LLC, THE SURGERY CENTER OF MIDDLE TENNESSEE | 621839266 - (TN) SURGERY CENTER OF MIDDLE TENNESSEE LLC | TN | 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 | $1306.00 | 1205929080 - OAK TREE SURGERY CENTER, LLC | 223524889 - (NJ) OAK TREE SURGERY CENTER, LL, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $400.00 | 1407016561 - THOMASVILLE SURGERY CENTER, INC. | 582233903 - (GA) THOMASVILLE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $583.00 | 1023010311 - BLUE RIDGE SURGICAL CENTER, LLC | 141854493 - (MO) BLUE RIDGE SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43332 | $809.00 | 1780959007 - COLUMBIA RIVER SURGERY CENTER LLC | 452481484 - (OR) COLUMBIA RIVER SURGERY CENTER, LLC | OR | 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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