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See a sample rate comparisonCPT 43338 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Esophageal Lengthening Procedu, Esophageal Lengthening Procedure (Eg Collis Gastroplasty Or Wedge Gastroplasty) (List Separately Inaddition To Code For Primary Procedure)
| 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 | GC - Service performed by resident under supervision 62 - Co-Surgeons 80 - Assistant surgeon |
| Complexity Level | Low |
| Medicare Fee Schedule | $103.54 national non-facility rate (2026) · View Medicare rates for 43338 |
| Medicaid Fee Schedule | $79.895 median of the 8 states in the free preview · View Medicaid rates for 43338 |
National average reimbursement for CPT 43338 by major payers:
$158.07
$170.81
$162.26
$202.41
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CPT 43338
5 of 25 sample ratesHigher to lower in this preview
Thr/Stt Southlake Asc, LLC
$6,068.00Published rateManchester Ambulatory Surgery Center Lp, Des Peres Square Surgery Center
$1,167.00Published rateCaromont Health Services, Inc., Caromont Specialty Surgery
Caromont Health Services Inc
$973.00Published rateArmenia Ambulatory Surgical Center, LLC
Armenia Ambulatory Surgical Center LLC
$512.00Published rateMontgomery Eye Surgery Center LLC, The Montgomery Eye Surgery Center
Montgomery Eye Surgery Center LLC
$150.00Published rate
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See a sample payer proposalCPT 43338 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43338 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 43338 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 |
|---|---|---|
| 43333-CPT | High | Repair Of A Stomach Hernia, Surgery To Repair A Stomach Hernia. The Protruding Stomach Is Moved Back Into Place And The Opening In The Diaphragm Is Stitched Smaller. Mesh May Be Implanted To Hold The Tissue In Place. |
| 43334-CPT | High | Repair Of A Stomach Hernia, Surgery To Repair A Stomach Hernia. The Protruding Stomach Is Moved Back Into Place And The Opening In The Diaphragm Is Stitched Smaller. Mesh May Be Implanted To Hold The Tissue In Place. |
| 43335-CPT | High | Repair Of A Stomach Hernia, Surgery To Repair A Stomach Hernia. The Protruding Stomach Is Moved Back Into Place And The Opening In The Diaphragm Is Stitched Smaller. Mesh May Be Implanted To Hold The Tissue In Place. |
| 43338-CPT | Low | Esophageal Lengthening Procedu, Esophageal Lengthening Procedure (Eg Collis Gastroplasty Or Wedge Gastroplasty) (List Separately Inaddition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43338. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43338 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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