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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 23 - Emergency Room |
| Common Modifiers | 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | $34.40 national non-facility rate (2026) · View Medicare rates for 43752 |
| Medicaid Fee Schedule | $27.94 median of the 8 states in the free preview · View Medicaid rates for 43752 |
National average reimbursement for CPT 43752 by major payers:

$53.99

$55.57

$61.17

$69.19
Choose a payer to see a sample of rates for CPT 43752.
Lakewood Surgery Center, LLC
Lakewood Surgery Center LLC
Summit View Surgery Center, LLC
Presbyterian Hospital Asc, New Mexico Surgery Center Multi-Specialty
Journey Lite Of Cincinnati, LLC
Journeylite Of Cincinnati, LLC
Md Laser Surgery Center, LLC
Md Laser Surgery Center LLC
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Rate Benchmarking
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See a sample payer proposalCPT 43752 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43752 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 43752 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 |
|---|---|---|
| 43752-CPT | Low | Nasal Orogastric W Tube Plmt, Naso Or Oro Gastric Tube Placement Requiring Physician S Skill And Fluoroscopic Guidance Includes Fluoroscopy Image Documentation And Report |
| 43753-CPT | Low | Therapy For Digestive Bleeding, A Tube Is Inserted Down The Throat (Intubation) Into The Stomach. The Procedure Removes Excess Blood From An Injury And May Include Therapeutic Washing Of The Internal Tissues. |
| 43754-CPT | Low | Stomach Fluid Collection, A Tube Is Inserted Down The Throat (Intubation) Into The Stomach. A Sample Of The Fluid Is Removed And Tested To Find Out What Is In It. Stomach Acid Secretion May Be Stimulated Prior To Taking The Fluid Sample. |
| 43755-CPT | Moderate | Dx Gastr Intub W Asp Specs, Gastric Intubation And Aspiration Diagnostic Collection Of Multiple Fractional Specimens With Gastric Stimulation Single Or Double Lumen Tube Gastric Secretory Study Eg Histamine Insulin Pentagastrin Calcium Secretin Includes Drug Administration |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43752. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43752 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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