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See a sample rate comparisonCPT 43653 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.
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.
| 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 | GC - Service performed by resident under supervision AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $565.14 national non-facility rate (2026) · View Medicare rates for 43653 |
| Medicaid Fee Schedule | $440.71 median of the 8 states in the free preview · View Medicaid rates for 43653 |
National average reimbursement for CPT 43653 by major payers:
$707.59
$757.86
$843.35
$923.76
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CPT 43653
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Willow Park LLC, Texas Health Orthopedic And Spine Surgery Center
Texas Health Surgery Center Willow Park LLC
$8,818.00Published rateBarkley Surgicenter, LLC
Barkley Surgicenter LLC
$6,365.00Published rateProhealth Aligned LLC, Prohealth Care Moreland Surgery Center
Prohealth Aligned LLC
$3,744.00Published rateHazleton Endoscopy Center, Inc.
Hazleton Endoscopy Center Inc
$1,691.00Published rateRetina Consultants Surgery Center
$851.00Published rate
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See a sample payer proposalCPT 43653 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43653 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 43653 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 |
|---|---|---|
| 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. |
| 43659-CPT | High | Laparoscopy Surgicalunlisted, Laparoscopy Surgicalunlisted Laparoscopy Procedure Stomach |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43653. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43653 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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