CPT 43651 Fee Schedule
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.
| 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 • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| CMS | $646.93 Physician Fee Schedule |
National average reimbursement for CPT 43651 by major payers:
$837.39
$874.83
$911.04
$1,075.91
| 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 43651 | ||||||
United | 43651 | $4818.00 | 1871838003 - NORTHWEST REGIONAL SURGERY CENTER, LLC | 460823847 - (IN) NORTHWEST REGIONAL SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $5000.00 | 1033141825 - GREENSPRING SURGERY CENTER LLC | 203320836 - (MD) GREENSPRING SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $4627.00 | 1588302707 - ALLINA HEALTH SURGERY CENTER- VADNAIS HEIGHTS LLC | 882406421 - (MN) ALLINA HEALTH SURGERY CENTER VADNAIS HEIGHTS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $3474.00 | 1588962831 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $1742.00 | 1518916758 - MOUNTAIN LAUREL SURGERY CENTER L.L.C. | 753187461 - (PA) MOUNTAIN LAUREL SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $7738.00 | 1053418137 - TRI-CITY REGIONAL SURGERY CENTER LLC | 911728399 - (WA) TRI-CITY REGIONAL SURGERY CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $1763.00 | 1710924881 - GEORGIA DERMASURGERY CENTERS, INC. | 582495671 - (GA) GEORGIA DERMASURGERY CENTERS INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $6492.00 | 1962714154 - SURGCENTER OF WHITE MARSH, LLC | 272873637 - (MD) SURGCENTER OF WHITE MARSH, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $3739.00 | 1437642857 - GEORGIA VASCULAR & VEIN CENTER | 822239594 - (GA) GEORGIA VASCULAR VEIN CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $4066.00 | 1124594338 - CHARLOTTE SURGERY CENTER, LLC | 561449531 - (NC) CHARLOTTE SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $2091.00 | 1043283294 - THE HUTCHINSON OPHTHALMOLOGY ASC LLC, SURGERY CENTER OF SOUTH CENTRAL KANSAS | 621822845 - (KS) THE HUTCHINSON OPHTHALMOLOGY ASC LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $1691.00 | 1275519373 - PROGRESSIVE LASER SURGICAL INSTITUTE LTD | 200172711 - (PA) PROGRESSIVE LASER SURGICAL INSTITUTE LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $4061.00 | 1922301712 - THE SURGERY CENTER AT WILLIAMSON LLC | 270929515 - (TX) THE SURGERY CENTER AT WILLIAMSON LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $6492.00 | 1902807159 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF SCOTTSDALE | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43651 | $550.00 | 1811052749 - GDC ENDOSCOPY CENTER LLC | 651240653 - (GA) GDC ENDOSCOPY CENTER LLC | GA | 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 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 |
|---|---|---|
| 43340-CPT | High | Esphagojejunostomy; Abdominal Approach |
| 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 | Laparoscopy; Transection Of Vagus Nerves, Truncal |
| 43652-CPT | Moderate | Laparoscopy; Transection Of Vagus Nerves, Selective Or Highly Selectiv |
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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