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See a sample rate comparisonCPT 43762 Fee Schedule
Last Verified: October 2026
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.
Replacement Of Gastrostomy Tub, Replacement Of Gastrostomy Tube Percutaneous Includes Removal When Performed Without Imaging Or Endoscopic Guidance Not Requiring Revision Of Gastrostomy Tract
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | AG - Primary physician UA |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $272.22 national non-facility rate (2026) · View Medicare rates for 43762 |
| Medicaid Fee Schedule | $203.99 median of the 8 states in the free preview · View Medicaid rates for 43762 |
National average reimbursement for CPT 43762 by major payers:
$250.15
$301.60
$329.89
$373.55
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CPT 43762
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Texas International Endoscopy Center, LLC, Texas International Endoscopy Center
$1,831.00Published rateScp Indianapolis LLC
$438.00Published rateMetroeast Endoscopic Surgery Center
$250.00Published rateGreenville Surgery Center Lp, Piedmont Surgery Center
Greenville Surgery Center Limited Partnership
$125.00Published rateTrevose Specialty Care Surgical Center, LLC
$77.00Published rate
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See a sample payer proposalCPT 43762 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43762 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 43762 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 |
| 43761-CPT | Low | Rposition Of A Naso- Or Oro-Gastric Feed Tube Through Duod, Repositioning Of A Naso- Or Oro-Gastric Feeding Tube Through The Duod |
| 43762-CPT | Moderate | Replacement Of Gastrostomy Tub, Replacement Of Gastrostomy Tube Percutaneous Includes Removal When Performed Without Imaging Or Endoscopic Guidance Not Requiring Revision Of Gastrostomy Tract |
| 43763-CPT | Moderate | Rplc Gtube Revj Gstrst Trc, Replacement Of Gastrostomy Tube Percutaneous Includes Removal When Performed Without Imaging Or Endoscopic Guidance Requiring Revision Of Gastrostomy Tract |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43762. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43762 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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Frequently Asked Questions
CPT (Current Procedural Terminology) codes are a standardized set of five-digit codes used by healthcare professionals to report medical, surgical, and diagnostic services and procedures to entities like insurers and government agencies. They are crucial for billing, reimbursement, and ensuring consistent communication across the healthcare system.
To find the cost of a specific medical procedure or service, you generally need the CPT code for that service and your geographic location. For accurate and specific pricing information, especially considering different insurance plans and providers, it's recommended to use a fee schedule lookup tool. You can utilize platforms like Payerprice, which offers a tool to search for fee schedules using CPT codes and specific locations.
You can look up fee schedules for medical services using specialized tools that allow you to search by CPT code and location. For a comprehensive and specific search that can include various payers (commercial, Medicare, etc.), you should utilize a platform like Payerprice, which provides a fee schedule lookup tool tailored for this purpose.
While CMS (Centers for Medicare & Medicaid Services) provides public fee schedules primarily for Medicare services, these rates may not reflect the actual costs or negotiated rates for all payers (e.g., private insurance). For a broader and more specific search that considers various payers and your exact location, including commercial rates, it is recommended to use a tool like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations, providing more relevant data for a wider range of scenarios beyond just Medicare.