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See a sample rate comparisonCPT 43659 Fee Schedule
Last Verified: October 2026
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.
Laparoscopy Surgicalunlisted, Laparoscopy Surgicalunlisted Laparoscopy Procedure 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 | AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 43659 |
| Medicaid Fee Schedule | $1,076.43 median of the 4 states in the free preview · View Medicaid rates for 43659 |
National average reimbursement for CPT 43659 by major payers:
$1,409.31
$401.96
$5,986.59
$2,621.53
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CPT 43659
5 of 25 sample ratesHigher to lower in this preview
Otay Lakes Surgery Center, LLC
Otay Lakes Surgery Center
$7,000.00Published rateUniversity Of Maryland Medicine Asc, LLC, University Of Maryland Surgery Center
University Of Maryland Medicine Asc LLC
$4,254.00Published rateArapahoe Surgicenter, LLC
$2,781.00Published rateUniversity Of Maryland Surgcial Assoc PA, University Of Maryland Urological Surgery Center
University Of Maryland Surgical Associates P A
$1,900.00Published rateMesquite Surgery Center LLC
Mesquite Surgery Center, LLC
$749.00Published rate
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See a sample payer proposalCPT 43659 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43659 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 43659 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 43659. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43659 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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