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CPT 43622 Fee Schedule

Last Verified: December 2025

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; With Formation Of Intestinal Pouch, Any Type
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

80 - Assistant surgeon

22 - Increased Procedural Services

Complexity LevelHigh
CMS$2,244.52 Physician Fee Schedule

National average reimbursement for CPT 43622 by major payers:

bcbs

$2,911.20

uhc

$3,050.57

aetna

$3,194.32

cigna

$3,708.79

Preview provider-level rates for...
For billing codeCPT 43622
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 43622

United
43622$670.001730409400 - EYE BONE, LLC, CHARDON SURGERY CENTER204691851 - (OH) EYE BONE, LLC DBA CHARDON SURGERY CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$599.001407223019 - VALLEY OUTPATIENT SERVICES, LLC474866031VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$380.001902876212 - SCAC LLC, SURGERY CENTER AT CRANBERRY562286973 - (PA) SCAC LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$452.001720509722 - CLEVELAND EAST VASCULAR CARE, LLC461853653 - (OH) CLEVELAND EAST VASCULAR CARE LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$450.001710420120 - AMERICAN ACCESS CARE OF MIAMI ASC LLC, AZURA SURGERY CENTER MIAMI814118495 - (FL) AMERICAN ACCESS CARE OF MIAMI ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$2705.001205899705 - EL PASO SURGERY CENTERS LP621846494 - (TX) EL PASO SURGERY CENTERS LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$624.001215178835 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$680.001821047499 - RIVERSIDE SURGERY CENTER, INC.680400319 - (CA) RIVERSIDE SURGERY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$260.001831280536 - EFFINGHAM SURGICAL PARTNERS LLC371409876 - (IL) EFFINGHAM SURGICAL PARTNERS, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$983.001811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER814378043FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$1049.001295344026 - WEST CHESTER SURGICAL SUITES, LLC845072006 - (OH) WEST CHESTER SURGICAL SUITES LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$512.001578917035 - HABANA AMBULATORY SURGERY CENTER LLC475162374 - (FL) HABANA AMBULATORY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$395.001699711382 - TOWSON SURGICAL CENTER LLC, TOWSON SURGICAL CENTER521945958 - (MD) TOWSON SURGICAL CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$1218.001346317039 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (PALM BEACH BASCOM PALMER - ASC)592579938 - UNIVERSITY OF MIAMIFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$469.001912196494 - VALDOSTA FOOT & ANKLE SURGERY CENTER, P.C.582556232 - (GA) VALDOSTA FOOT ANKLE SURGERY CENTER PCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
43620-CPTHighGastrectomy,Total;Intestinal Anast.
43621-CPTHighGastrectomy, Total; With Roux-En-Y Reconstruction
43622-CPTHighGastrectomy, Total; With Formation Of Intestinal Pouch, Any Type
43632-CPTHighGastrectomy, Partial, Distal; With Gastrojejunostomy

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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