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See a sample rate comparisonCPT 43622 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.
Gastrectomy Total; W/ Formation Of Intestin Pouch Any Typ, Gastrectomy Total; With Formation Of Intestinal Pouch Any Type
| 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 | 80 - Assistant surgeon 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | $2,129.31 national non-facility rate (2026) · View Medicare rates for 43622 |
| Medicaid Fee Schedule | $1,648.13 median of the 8 states in the free preview · View Medicaid rates for 43622 |
National average reimbursement for CPT 43622 by major payers:
$2,911.20
$3,050.57
$3,194.32
$3,626.00
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CPT 43622
5 of 25 sample ratesHigher to lower in this preview
Southwest Washington Regional Surgery Center, LLC
Southwest Washington Regional Surgery Center
$1,399.00Published rateTemecula Ca Endoscopy Asc Lp, Temecula Valley Endoscopy Center
Temecula Ca Endoscopy Asc Lp
$799.00Published rateUnova Asc, Inc
Unova Asc Inc
$562.00Published rateSoutheast Eye Surgery Center, LLC
Southeast Eye Surgery Center LLC
$385.00Published rateEye Associates Of Manatee LLP, Eye Associates Surgery Center
The Eye Associates
$50.00Published rate
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See a sample payer proposalCPT 43622 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43622 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 43622 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 |
|---|---|---|
| 43620-CPT | High | Remove Stomach Join To Bowel, Surgery To Remove The Stomach. The Procedure Includes The Formation Of A New Connection Between The Esophagus And The Intestine. |
| 43621-CPT | High | Gastrectomy, Total; With Roux-En-Y Reconstruction |
| 43622-CPT | High | Gastrectomy Total; W/ Formation Of Intestin Pouch Any Typ, Gastrectomy Total; With Formation Of Intestinal Pouch Any Type |
| 43632-CPT | High | Surgery To Remove Stomach Part, Surgery To Remove A Section Of The Stomach. The Procedure Involves Creation Of A New Connection To The Intestines. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43622. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43622 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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