CPT 43763 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 • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $313.76 Physician Fee Schedule |
National average reimbursement for CPT 43763 by major payers:
$364.43
$449.71
$481.87
$544.80
| 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 43763 | ||||||
United | 43763 | $547.44 | 1801813266 - GREGG BEAN | 741671142 - (TX) SOUTH TEXAS RADIOLOGY GROUP, P.A. | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 43763 | $574.53 | 1457371775 - DEACONESS HOSPITAL, INC., <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 43763 | $471.27 | 1801813266 - GREGG BEAN | 741586031 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 43763 | $574.53 | 1639331317 - OSAZE EDO-OHONBA | 350593390 - DEACONESS HOSPITAL INC | MO | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 43763 | $547.44 | 1801813266 - GREGG BEAN | 741671142 - (TX) SOUTH TEXAS RADIOLOGY GROUP, P.A. | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 43763 | $263.98 | 1124526611 - KATHLEEN QUATRO | 350593390 - DEACONESS HOSPITAL INC | KY | Family Nurse Practitioner (363LF0000X) |
United | 43763 | $574.53 | 1932631520 - QUANG NGUYEN | 350593390 - DEACONESS HOSPITAL INC | KY | Sleep Medicine (Internal Medicine) Physician (207RS0012X) |
United | 43763 | $574.53 | 1356676480 - KHAWAJA ZAKI | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 43763 | $353.54 | 1548787203 - DEACONESS HOSPITAL, INC., <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Radiology Clinic/Center (261QR0200X) |
United | 43763 | $574.53 | 1013222322 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Pain Medicine Physician (208VP0000X) |
United | 43763 | $574.53 | 1528324068 - RENUKA ANANTH KALYAN KADALI | 350593390 - DEACONESS HOSPITAL INC | NC | Internal Medicine Physician (207R00000X) |
United | 43763 | $574.53 | 1811301666 - HEMAPRIYA GOPAL REDDY | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 43763 | $574.53 | 1881031821 - LINDSEY TAYLOR | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatrics Physician (208000000X) |
United | 43763 | $263.98 | 1164469722 - TERRY HOFF | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 43763 | $263.98 | 1447825377 - PAIGE RUDDICK | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
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 43763 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43763 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 43763 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 |
| 43763-CPT | Moderate | 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 43763. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43763 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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