CPT 43762 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 • 11 - Office |
| Common Modifiers | • None • AG - Primary physician • UA |
| Complexity Level | Moderate |
| CMS | $212.52 Physician Fee Schedule |
National average reimbursement for CPT 43762 by major payers:
$250.15
$301.60
$329.89
$390.80
| 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 43762 | ||||||
United | 43762 | $1446.00 | 1093383655 - SHERMAN ENDOSCOPY CENTER, LLC | 861402910 - (TX) SHERMAN ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $246.00 | 1235240813 - NORTH MISSISSIPPI AMBULATORY SURGERY CENTER LLC | 200145190 - (MS) NORTH MISSISSIPPI AMBULATORY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $1969.00 | 1528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC | 202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $183.00 | 1245566744 - CHESTERFIELD ASC, LLC | 811166184 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $808.00 | 1043283906 - NAUGATUCK VALLEY ENDOSCOPY CENTER, LLC, WATERBURY SURGERY CENTER | 260078381 - (CT) NAUGATUCK VALLEY ENDOSCOPY CENTE | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $279.00 | 1972778579 - G A ENDOSCOPY CENTER, LLC | 262346936 - (MO) G A ENDOSCOPY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $200.00 | 1780322750 - QUEENSRIDGE SURGERY CENTER | 862358950 - (NV) QUEENSRIDGE SURGERY CENTER | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $574.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $688.00 | 1366416125 - TEXAS ORTHOPEDICS SURGERY CENTER, LLC, TEXAS ORTHOPEDICS SURGERY CENTER LIMITED PARTNERSHIP, LL | 743013713 - (TX) TEXAS ORTHOPEDICS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $212.00 | 1073663480 - DOCTORS CLINIC A PROFESSIONAL CORPORATION, THE DOCTORS CLINIC AMBULATORY SURGERY CENTER | 911939739 - FRANCISCAN MEDICAL GROUP | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $603.00 | 1154322410 - SUMMIT SURGICAL SUITES, LLC, SOUTHWEST SURGICAL SUITES | 383641574 - (IN) SUMMIT SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $544.00 | 1467415513 - LAS VEGAS SURGICARE LTD | 880244070 - (NV) LAS VEGAS SURGICARE LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $566.00 | 1811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER | 814378043 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $574.00 | 1184687386 - DIGESTIVECARE, LLC, DIGESTIVECARE ENDOSCOPY UNIT | 311108485 - (OH) DIGESTIVE CARE, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43762 | $1029.00 | 1184877219 - THR/STT ROCKWALL ASC, LLC | 262429878 | 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 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 | 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 |
| 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 |
| 43762-CPT | Moderate | Replacement Of Gastrostomy Tube, Percutaneous, Includes Removal, When Performed, Without Imaging Or Endoscopic Guidance; Not 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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