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See a sample rate comparisonHealthcare 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.
| 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 | 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $633.95 national non-facility rate (2026) · View Medicare rates for 43651 |
| Medicaid Fee Schedule | $496.615 median of the 8 states in the free preview · View Medicaid rates for 43651 |
National average reimbursement for CPT 43651 by major payers:

$837.39

$874.83

$911.04

$1,053.31
Choose a payer to see a sample of rates for CPT 43651.
Tri-City Regional Surgery Center LLC
Tri-City Regional Surgery Center
Southern Surgery Center, LLC
Southern Surgery Center LLC
4th Street Laser & Surgery Center Inc
Fourth Street Laser & Surgery
G A Endoscopy Center, LLC
G A Endoscopy Center LLC
Gdc Endoscopy Center LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 43651 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43651 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 43651 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 |
|---|---|---|
| 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 |
| 43651-CPT | Moderate | Surgery On Stomach Nerve, Surgery Aided By A Scope (Laparoscope) To Remove A Section Of The Vagus Nerve. This Nerve Controls The Openings Into And Out Of The Stomach. |
| 43652-CPT | Moderate | Surgery On Stomach Nerve, Surgery Aided By A Scope (Laparoscope) To Remove A Section Of The Vagus Nerve. This Nerve Controls The Openings Into And Out Of The Stomach. |
| 43653-CPT | Moderate | Scope Surgery For Feeding Tube, Surgery Aided By A Scope (Laparoscope) To Create An Opening In The Stomach For The Placement Of A Feeding Tube. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43651. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43651 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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