CPT 43753 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 | • 23 - Emergency Room • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Low |
| CMS | $20.70 Physician Fee Schedule |
National average reimbursement for CPT 43753 by major payers:
$30.40
$30.27
$32.53
$45.93
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 43753 | ||||||
United | 43753 | $300.00 | 1649416231 - CLINTON PARTNERS, LLC, SURGERY CENTER OF CLINTON TOWNSHIP | 202236024 | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $366.00 | 1801450986 - DOCTORS HOSPITAL, INC, BAPTIST HEALTH SURGERY CENTER CORAL GABLES | 43775926 - (FL) DOCTORS HOSPITAL INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $1110.75 | 1437114378 - EMERALD COAST SURGERY CENTER, LP, EMERALD COAST SURGERY CENTER | 621502718 - (FL) EMERALD COAST SURGERY CENTER LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $77.00 | 1811932270 - PHILADELPHIA SURGI CENTER, INC. | 232965126 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $500.00 | 1376716316 - CPM SURGERY CENTER LLC | 261382311 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $555.00 | 1992992994 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $250.00 | 1760923445 - DIALYSIS ACCESS CENTER A MEDICAL CORPORATION | 522384032 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $365.00 | 1083674196 - VISION CARE CENTER OF IDAHO LLC | 820516189 - (ID) VISION CARE CENTER OF IDAHO LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $91.00 | 1194712109 - EXECUTIVE ENDOSCOPY, INC, ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $230.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $116.00 | 1437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC | 463556921 - (NC) PRIME SURGICAL SUITES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $300.00 | 1730355595 - FORT MYERS ENDOSCOPY CENTER LLC | 800149158 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $250.00 | 1538189907 - INDEPENDENT PRACTIONERS OF AMERICA, LLC | 450455462 - (ND) INDEPENDENT PRACTITIONERS OF AMERICA, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $126.00 | 1528099207 - DEER CREEK SURGERY CENTER, LLC | 202255269 - (KS) DEER CREEK SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43753 | $555.00 | 1154956928 - ADVANCED SURGICAL CARE OF CLEARWATER LLC | 833698204 - (FL) ADVANCED SURGICAL CARE OF CLEARWATER LLC | FL | 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 43753 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43753 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 43753 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 | Naso- Or Oro-Gastric Tube Placement Requiring Physicians Skill And Fluoroscopic Guidance (Includes Fluoroscopy Image Documentation And Report) (Rvsd 1/1/04) |
| 43753-CPT | Low | Once Per Dos Gastric Intubation And Aspiration(S) Therapeutic, Necessitating Physician's Skill (Eg, For Gastrointestinal Hemorrhage), Including Lavage If Performed |
| 43754-CPT | Low | Once Per Dos Gastric Intubation And Aspiration, Diagnostic; Single Specimen (Eg, Acid Analysis) |
| 43755-CPT | Moderate | 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 43753. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43753 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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