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CPT 43622 Fee Schedule

Last Verified: January 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; 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
Medicare Fee ScheduleView Medicare rates for 43622

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$840.001417912353 - WINTER PARK SURGERY CENTER LP, PHYSICIAN'S SURGICAL CARE CENTER621525776 - (FL) WINTER PARK SURGERY CENTER LPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$385.001447599659 - SOUTHEAST EYE SURGERY CENTER, LLC455054338 - (TN) SOUTHEAST EYE SURGERY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$560.001821106923 - ENDOSCOPY CENTER OF COASTAL GEORGIA, LLC582628189 - (GA) ENDOSCOPY CENTER OF COASTAL GEORGIA LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$799.001477527398 - TEMECULA CA ENDOSCOPY ASC LP, TEMECULA VALLEY ENDOSCOPY CENTER200095307 - (CA) TEMECULA CA ENDOSCOPY ASC LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$591.001033102140 - SSC HOLDINGS LLC, SEDONA SURGERY CENTER470887316 - (CA) SSC HOLDINGS LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$1049.001730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$840.001548842180 - DIGESTIVE HEALTH CENTER LLC853810510 - (IA) DIGESTIVE HEALTH CENTER LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$350.001225490196 - OLNEY ENDOSCOPY CENTER473544166 - (MD) OLNEY ENDOSCOPY CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$234.001629142666 - ENDOSCOPY CENTER OF BUCKS COUNTY, LP841693856 - (PA) ENDOSCOPY CENTER OF BUCKS COUNTY LPPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$50.001568460889 - EYE ASSOCIATES OF MANATEE LLP, EYE ASSOCIATES SURGERY CENTER650105559 - (FL) THE EYE ASSOCIATESFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$351.001225050347 - STATE HILL SURGICENTER LLC203106650PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$100.001659683662 - PREMIER ENDOSCOPY CENTER, LLC272932575 - (AZ) PREMIER ENDOSCOPY CENTER, P.L.L.C.AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$750.001851865828 - ATLANTA SURGERY NORTH832134639 - (GA) ATLANTA SURGERY NORTHGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$555.001841222353 - DAY-OP CENTER OF LONG ISLAND LLC, DAY-OP CENTER OF LONG ISLAND112811353 - (NY) DAY OP CENTER OF LONG ISLAND INCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
43622$797.001689003766 - CANYON VIEW ASC, LLC, CANYON VIEW ASC455352976 - (CO) CANYON VIEW ASC LLCCOAmbulatory 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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