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See a sample rate comparisonCPT 43652 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 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.
| 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 | 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $732.48 national non-facility rate (2026) · View Medicare rates for 43652 |
| Medicaid Fee Schedule | $572.645 median of the 8 states in the free preview · View Medicaid rates for 43652 |
National average reimbursement for CPT 43652 by major payers:
$993.04
$1,025.38
$1,056.86
$1,229.78
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CPT 43652
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$14,053.00Published rateBaptist Medical Park Surgery Center, LLC
Baptist Medical Park Surgery Center LLC
$5,277.00Published rateMid-Atlantic Endoscopy Center, LLC, Mid-Atlantic Gastrointestinal Center II
Midatlantic Endoscopy Center LLC
$2,816.00Published rateFounders Surgery Center, LLC
$1,599.00Published rateDoctors Surgery Center LLC
$812.00Published rate
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See a sample payer proposalCPT 43652 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43652 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 43652 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 43652. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43652 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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