CPT 43752 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 23 - Emergency Room |
| Common Modifiers | None 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 43752 |
National average reimbursement for CPT 43752 by major payers:
$53.99
$55.57
$61.17
$69.19
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 43752 | $375.00 | 1285608075 - PUEBLO CO OPHTHALMOLOGY ASC LLC, ROCKY MOUNTAIN LASER & SURGERY CENTER | 200121336 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $574.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $150.00 | 1124587548 - GATEWAY SURGICAL CENTER, LLC | 830521568 - (TX) GATEWAY SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $70.00 | 1558787614 - DIGESTIVE CARE ENDOSCOPY | 464923646 - (GA) DIGESTIVE CARE ENDOSCOPY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $210.00 | 1548233794 - METAIRIE OPHTHALMOLOGY ASC LLC, AMBULATORY EYE SURGERY CENTER OF LOUISIANA | 621822003 - (LA) THE METAIRIE OPHTHALMOLOGY ASC, LLC DBA AMBULATORY EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $125.00 | 1144745951 - METROPOLITAN SURGICAL CENTER, LLC | 821761609 - (MN) METROPOLITAN SURGICAL CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $624.00 | 1205808938 - ABILENE EYE ASC LP, ABILENE CATARACT AND REFRACTIVE SURGERY CENTER | 621678444 - (TX) ABILENE EYE ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $1112.00 | 1780673327 - LAKEWOOD SURGERY CENTER, LLC | 371470145 - (NJ) LAKEWOOD SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $80.00 | 1346349164 - SOUTHERN ALABAMA SURGERY CENTER LLC, SURGERY CENTER SOUTH | 621827534 - (AL) SOUTHERN ALABAMA SURGERY CENTER, LL | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $238.00 | 1780764829 - NOVAMED SURGERY CENTER OF ST PETERS LLC, ST PETERS AMBULATORY SURGERY CENTER | 205579933 - (MO) NOVAMED SURGERY CENTER OF ST PETERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $432.00 | 1659516375 - BROOKLYN ENDOSCOPY SC, LLC, GNYESC | 205479673 - (NY) BROOKLYN ENDOSCOPY SC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $190.00 | 1568513950 - MASSACHUSETTS AVENUE SURGERY CENTER | 200815305 - (MD) MASSACHUSETTS AVENUE SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $574.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $131.00 | 1952518029 - RALEIGH NC ENDOSCOPY ASC LLC, RALEIGH ENDOSCOPY CENTER - CARY | 200864597 - (NC) RALEIGH NC ENDOSCOPY ASC LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43752 | $737.00 | 1275886319 - SURGERY CENTER OF BAY AREA HOUSTON, LLC | 320383244 | TX | 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 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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