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See a sample rate comparisonCPT 43400 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.
Ligate Esophageal Varices Direct
| 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 | 51 - Multiple procedures 82 - Assistant surgeon - no qualified resident AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | $1,420.21 national non-facility rate (2026) · View Medicare rates for 43400 |
| Medicaid Fee Schedule | $1,098.535 median of the 8 states in the free preview · View Medicaid rates for 43400 |
National average reimbursement for CPT 43400 by major payers:
$1,860.15
$2,028.13
$2,093.24
$2,415.64
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CPT 43400
5 of 25 sample ratesHigher to lower in this preview
Pottstown Hospital Company LLC, Pottstown Memeorial Medical Center
$7,354.00Published rateThe Polyclinic, The Polyclinic Plastic Surgery Center
The Polyclinic, PLLC
$5,547.00Published rateChicago Prostate Cancer Surgery Center, LLC, Dupage Medical Group Surgery Center, Westmont
Chicago Prostate Cancer Surgery Center LLC
$3,563.00Published rateSurgery Center Jv, The Surgery Center Of Huntsville
The Surgery Center Of Huntsville
$2,350.00Published ratePharos Enterprises Of Wisconsin, LLC
Pharos Enterprises Of Wisconsin LLC
$1,273.00Published rate
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See a sample payer proposalCPT 43400 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43400 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 43400 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 |
|---|---|---|
| 43351-CPT | High | Surgery For Esophagus Opening, Surgery To Create An Artificial Opening (Fistula) Into The Esophagus From The Outside Of The Body. |
| 43352-CPT | High | Surgery For Esophagus Opening, Surgery To Create An Artificial Opening (Fistula) Into The Esophagus From The Outside Of The Body. |
| 43360-CPT | High | Gastrointestinal Repair, Gastrointestinal Reconstruction For Previous Esophagectomy For Obstructing Esophageal Lesion Or Fistula Or For Previous Esophageal Exclusion With Stomach With Or Without Pyloroplasty |
| 43400-CPT | High | Ligate Esophageal Varices Direct |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43400 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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