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See a sample rate comparisonCPT 43635 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery On Nerve In Abdomen, Surgery To Cut The Vagus Nerve A Major Nerve That Runs Through The Abdomen To The Stomach And Intestines. The Procedure Includes Partial Removal Of The Stomach.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 80 - Assistant surgeon 82 - Assistant surgeon - no qualified resident AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | $100.87 national non-facility rate (2026) · View Medicare rates for 43635 |
| Medicaid Fee Schedule | $88.055 median of the 8 states in the free preview · View Medicaid rates for 43635 |
National average reimbursement for CPT 43635 by major payers:
$146.98
$153.90
$158.27
$181.74
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CPT 43635
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$17,689.00Published rateBsc Reid Park LLC
$1,124.00Published rateMile High Surgicenter, LLC
$874.00Published rateColumbus Orthopedic Outpatient
$658.00Published rateEndotech, LLC
Endotech LLC
$200.00Published rate
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See a sample payer proposalCPT 43635 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43635 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 43635 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 |
|---|---|---|
| 43631-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. |
| 43633-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. |
| 43634-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. |
| 43635-CPT | Low | Surgery On Nerve In Abdomen, Surgery To Cut The Vagus Nerve A Major Nerve That Runs Through The Abdomen To The Stomach And Intestines. The Procedure Includes Partial Removal Of The Stomach. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43635 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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