CPT 43340 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 51 - Multiple procedures • XS - Separate Structure • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| CMS | $1,346.91 Physician Fee Schedule |
National average reimbursement for CPT 43340 by major payers:
$1,700.28
$1,831.36
$1,896.18
$2,235.68
| 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 43340 | ||||||
United | 43340 | $575.00 | 1689608697 - ADVANCED COLON CARE INC, SHORELINE COLONOSCOPY SUITES | 61562707 - (CT) ADVANCED COLON CARE INC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $686.00 | 1184699241 - SAN LUIS OBISPO CA ENDOSCOPY ASC LP, TEMPLETON ENDOSCOPY CENTER | 201965605 - (CA) SAN LUIS OBISPO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $1000.00 | 1710904701 - ENDOSCOPIC DIAGNOSTIC & TREATMENT CENTER LLC | 770611981 - (NY) ENDOSCOPIC DIAGNOSTIC TREATMENT CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $498.00 | 1124083878 - THREE GABLES SURGERY CENTER LLC | 870648900 - (OH) THREE GABLES SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $1306.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $600.00 | 1811028293 - IEC SURGICAL CENTERS LLC, PHYSICIANS SURGERY CENTER | 204233454 - (MO) IEC SURGICAL CENTERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $500.00 | 1114549987 - SAN LUIS WALK-IN CLINIC, INC., SAN LUIS OUTPATIENT SURGERY CENTER | 651170616 - (AZ) SAN LUIS WALK-IN CLINIC INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $100.00 | 1790172922 - YUMA VALLEY AMBULATORY PAIN SERVICES INC | 471779727 - (AZ) YUMA VALLEY AMBULATORY PAIN SERVICES INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $100.00 | 1164601696 - SALVATORE DIMERCURIO MD PA | 521833726 - (MD) SALVATORE DIMERCURIO, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $1955.00 | 1811995913 - DALLAS SURGICAL PARTNERS, LLC, BAYLOR SCOTT & WHITE SURGICARE | 752813815 - (TX) DALLAS SURGICAL PARTNERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $1064.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $430.00 | 1407954365 - ASC-TCG, LLC, TRI-COUNTY CENTER FOR ENDOSCOPY & SURGERY | 43692535 - (MI) ASC - TCG LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $327.00 | 1336208081 - ATLANTIC SURGERY CENTER OF JACKSONVILLE BEACH | 593740436 - (FL) ATLANTIC SURGERY CENTER OF JACKSONVILLE BEACH | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $867.00 | 1912600826 - SURGICAL CENTER OF TVH | 882585662 - (ID) SURGICAL CENTER OF TVH | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43340 | $475.00 | 1568466209 - BAYVIEW MEDICAL CENTER, INC, LMC AMBULATORY SURGERY CENTER | 541593723 | VA | 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 43340 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43340 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 43340 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 | Once Per Dos Repair, Paraesophageal Hiatal Hernia (Including Fundoplication), Via Laparotomy, Except Neonatal; With Implantation Of Mesh Or Other Prosthesis |
| 43335-CPT | High | Once Per Dos Repair, Paraesophageal Hiatal Hernia (Including Fundoplication), Via Thoracotomy, Except Neonatal; With Implantation Of Mesh Or Other Prosthesis |
| 43340-CPT | High | Esphagojejunostomy; Abdominal Approach |
| 43341-CPT | High | Esophagojejunostomy Thoracic Appr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43340. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43340 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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