CPT 43632 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 80 - Assistant surgeon |
| Complexity Level | High |
| CMS | $1,980.90 Physician Fee Schedule |
National average reimbursement for CPT 43632 by major payers:
$2,494.28
$2,639.68
$2,882.55
$3,237.72
| 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 43632 | ||||||
United | 43632 | $849.00 | 1528016789 - HAMILTON SURGERY CENTER L.L.C., SURGER CENTER AT HAMILTON | 830358914 - (NJ) HAMILTON SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $1028.00 | 1316508252 - MINIMALLY INVASIVE SURGICENTER LLC | 842130499 - (FL) MINIMALLY INVASIVE SURGICENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $630.00 | 1740629245 - SURGERY AFFILIATES, LLC, PINNACLE SURGERY CENTER | 453011327 - (CO) SURGERY AFFILIATES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $1274.00 | 1114196151 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $440.00 | 1780664185 - HILLMONT ASC LP, SPRINGFIELD AMBULATORY SURGERY CENTER | 621641866 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $900.00 | 1134363690 - OAM SURGERY CENTER AT MIDTOWNE, LLC, METRO HEALTH OAM SURGERY CENTER | 261805066 - (MI) OAM SURGERY CENTER AT MIDTOWNE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $983.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $1028.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $525.00 | 1104829597 - HOGAN SURGICAL CENTER, P. A. | 300399671 - (MS) HOGAN SURGICAL CENTER P A | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $393.00 | 1013513308 - JOHN KENYON AMERICAN EYE INSTITUTE LLC, EYE SURGERY CENTER OF ELIZABETHTOWN | 351907389 - JOHN-KENYON AMERICAN EYE INSTITUTE | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $350.00 | 1356305916 - THE ROME ENDOSCOPY CENTER | 581866240 - (GA) THE ROME ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $595.00 | 1730130246 - PENNSYLVANIA EYE SURGERY CENTER, INC., MEMORIAL EYE INSTITUTE | 232262909 - (PA) PENNSYLVANIA EYE SURGERY CENTER, INC. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $7400.00 | 1558876037 - BELTWAY SURGERY CENTERS, LLC, EAST WASHINGTON SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $100.00 | 1649662206 - ADVANCED SURGERY CENTER OF ARIZONA, LLP, ADVANCED SURGERY CENTER OF ARIZONA | 471883984 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43632 | $526.00 | 1871538140 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS | 330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATION | CA | 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 43632 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43632 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 43632 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43632. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43632 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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