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See a sample rate comparisonCPT 43641 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.
Vagotomy Inclu Pyloroplasty W//W/O Gastrostomy; Parietal, Vagotomy Including Pyloroplasty With Or Without Gastrostomy; Parietal
| 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 | JZ - Zero drug amount discarded/not administered to any patient AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $1,133.63 national non-facility rate (2026) · View Medicare rates for 43641 |
| Medicaid Fee Schedule | $877.995 median of the 8 states in the free preview · View Medicaid rates for 43641 |
National average reimbursement for CPT 43641 by major payers:
$1,557.16
$1,590.95
$1,670.31
$1,907.16
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CPT 43641
5 of 25 sample ratesHigher to lower in this preview
River Drive Surgery Center, LLC, River Drive Surgery And Laser Center
River Drive Surgery Center L L
$4,300.00Published rateLivingston Asc LLC
$1,376.00Published rateVision Care Center, A Medical Group Inc, Eye-Q Surgery Center
Vision Care Center, A Medical Group, Inc.
$782.00Published rateSummit Endoscopy Center
$500.00Published rateArizona Advanced Surgery Center, LLC
Arizona Advanced Surgery Center LLC
$100.00Published rate
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See a sample payer proposalCPT 43641 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43641 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 43641 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 |
|---|---|---|
| 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. |
| 43640-CPT | High | Vagotomy Inclu Pyloroplasty W//W/O Gastrostomy; Truncal, Vagotomy Including Pyloroplasty With Or Without Gastrostomy; Truncal |
| 43641-CPT | High | Vagotomy Inclu Pyloroplasty W//W/O Gastrostomy; Parietal, Vagotomy Including Pyloroplasty With Or Without Gastrostomy; Parietal |
| 43644-CPT | High | Stomach Weight Loss Surgery, Stomach Surgery Aided By A Scope (Laparoscope). The Procedure Reduces The Size Of The Stomach Or Creates A Route For Food That Bypasses 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 43641. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43641 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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