CPT 43648 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 43648 by major payers:
$2,317.67
$966.31
$741.41
$1,945.93
| 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 43648 | ||||||
United | 43648 | $1907.00 | 1003875873 - WILDCREEK SURGERY CENTER | 880377689 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $16257.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $5354.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $4781.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $2285.00 | 1083780662 - PLASTIC SURGICENTRE, INC, THE PLASTIC SURGICENTRE, INC | 911473281 - (WA) THE PLASTIC SURGICENTRE, INC. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $5020.00 | 1114126596 - CORAL RIDGE OUTPATIENT CENTER LLC, CORAL RIDGE OUTPATIENT CENTER | 205429299 - (FL) CORAL RIDGE OUTPATIENT CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $785.00 | 1164871075 - CENTRAL ARIZONA GI & LIVER INSTITUTE LLC | 812583508 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $1150.00 | 1073581880 - AMBULATORY SURGERY CENTER LLC, THE CENTER FOR SAME DAY SURGERY | 481114690 - (KS) AMBULATORY SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $700.00 | 1386604908 - MATTAX NEU PRATER SURGERY CENTER, LLC | 431842771 - (MO) MATTAX NEU PRATER SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $2801.00 | 1710924899 - DMG SURGICAL CENTER LLC, SURGICAL CENTER OF DUPAGE MEDICAL GROUP | 371474161 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $5020.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $3003.00 | 1821276353 - PEND OREILLE SURGERY CENTER LLC | 300430739 - (ID) PEND OREILLE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $926.00 | 1396738936 - WARREN GASTRO ENDOSCOPY CTR INC | 341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $15626.00 | 1578561890 - THE ENDOSCOPY CENTER AT ST. FRANCIS, LLC | 351958962 - (IN) THE ENDOSCOPY CENTER AT ST FRANCIS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43648 | $4162.00 | 1023070026 - TOMS RIVER SURGERY CENTER, LLC, TOMS RIVER SURGERY CENTER | 752854783 - (NJ) TOMS RIVER SURGERY CENTER LLC | NJ | 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 43648 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43648 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 43648 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 |
|---|---|---|
| 43644-CPT | High | Laparoscopy Surgical Gastric Restrictive Pro- Cedure; With Gastric Bypass And Roux-En-Y Gastro- Enterostomy (Roux Limb 150 Cm Or Less) |
| 43645-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; W/ Gastric Bypass & Small Intestine Reconstruction To Limit Absorption- Rn Review |
| 43647-CPT | High | Once Per Dos Lap Surgical; Implant/Replace Gastric Neurostimulator Electrodes, Antrum - Nurse Review>12/30/2022: Deny Inv/N10=1/1/2007-12/30/2022 |
| 43648-CPT | High | Laparoscopy, Surgical; Revision Or Removal Of Gastric Neurostimulator Electrodes, Antrum - Nurse Review>12/30/2022: Deny Inv/N10=1/1/2007-12/30/2022 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43648. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43648 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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