CPT 43757 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 52 - Reduced Services |
| Complexity Level | Moderate |
| CMS | $345.14 Physician Fee Schedule |
National average reimbursement for CPT 43757 by major payers:
$396.39
$434.13
$478.76
$603.47
| 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 43757 | ||||||
United | 43757 | $1976.00 | 1770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA | 364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $1899.00 | 1164019485 - WAUKESHA SURGICENTER, LLC | 854083608 - (WI) WAUKESHA SURGICENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $1558.00 | 1063598597 - CLEAR CREEK SURGERY CENTER LLC | 200871085 - (CO) CLEAR CREEK SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $2003.00 | 1336204668 - PHYSICIANS SURGICENTER LLC | 223550463 - (NJ) PHYSICIANS' SURGICENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $2817.00 | 1730146861 - CONROE SURGERY CENTER 2, LLC | 760697645 - (TX) CONROE SURGERY CENTER 2 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $1528.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $2597.00 | 1962435990 - NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC, CENTER FOR BONE AND JOINT SURGERY | 201026094 - (NJ) NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $947.00 | 1154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE | 871712552 - (AZ) BSC 3 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $800.00 | 1750420147 - INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER, ISPM ASC | 205896580 - (GA) INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $722.00 | 1316015738 - KRAMBERG OBS | 205126110 - (NJ) KRAMBERG OBS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $750.00 | 1750434759 - TOWER OAKS SURGERY CENTER, LLC | 204877029 - (MD) TOWER OAKS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $667.00 | 1902447386 - SEATTLE PAIN RELIEF PLLC, FEDERAL WAY AMBULATORY SURGICAL FACILITY | 455527273 - (WA) SEATTLE PAIN RELIEF PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $1276.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $2307.00 | 1336180173 - BELTWAY SURGERY CENTERS LLC | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43757 | $936.00 | 1811914625 - PUGET SOUND GASTROENTEROLOGY, PLLC, EDMONDS ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | 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 43757 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43757 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 43757 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) |
| 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 |
| 43756-CPT | Moderate | Once Per Dos Duodenal Intubation And Aspiration, Diagnostic, Includes Image Guidance; Single Specimen (Eg, Bile Study For Crystals Or Afferent Loop Culture) |
| 43757-CPT | Moderate | Duodenal Intubation And Aspiration Diagnostic Includes Image Guidance; Single Specimen (Eg Bile Study For Crystals Or Afferent Loop Culture) Collection Of Mulitple Fractional Specimens With Pancreatic Or Gallbladder Stimulation Single Or Double Lumen Tube 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 43757. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43757 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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