CPT 43770 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • 80 - Assistant surgeon • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 43770 |
National average reimbursement for CPT 43770 by major payers:
$1,584.53
$1,498.38
$1,643.37
$1,855.44
| 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 43770 | ||||||
United | 43770 | $7200.00 | 1003847500 - WESTSIDE OUTPATIENT CENTER, LLC, PALMS WELLINGTON SURGICAL CENTER | 651078372 - (FL) WESTSIDE OUTPATIENT CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $3474.00 | 1053560896 - ASC DEVELOPMENT COMPANY, LLC, NATIONAL SPINE AND PAIN CENTERS | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $2266.00 | 1821285073 - GLENDORA CA ENDOSCOPY ASC LP, GLENDORA DIGESTIVE DISEASE INSTITUTE | 205732678 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $1046.00 | 1528024114 - AMBULATORY CARE CENTER PA | 223479837 - (NJ) AMBULATORY CARE CENTER PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $1900.00 | 1952364002 - SURGICARE OF CENTRAL FLORIDA LTD, CENTRAL FLORIDA SURGICENTER | 752556633 - (FL) SURGICARE OF CENTRAL FLORIDA, LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $16170.00 | 1962505354 - PROVIDENCE HEALTH SERVICES OF WACO, PROVIDENCE HEALTH CENTER | 741109636 - (TX) ASCENSION PROVIDENCE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $7888.00 | 1538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE | 833008593 - (FL) ASC OF TRINITY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $6168.00 | 1306201124 - CHRISTUS SANTA ROSA OUTPATIENT SURGERY, CHRISTUS PHYSICIANS SURGERY CENTER - SAN MARCOS | 810571409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $1508.00 | 1598744732 - MIDWEST EYE SURGERY CENTER, LLC | 470831193 - (NE) MIDWEST EYE SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $4865.00 | 1205566544 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $4038.00 | 1689003766 - CANYON VIEW ASC, LLC, CANYON VIEW ASC | 455352976 - (CO) CANYON VIEW ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $1645.00 | 1942455449 - HEA GRAMERCY SURGERY CENTER, PLLC, HEA SURGERY CENTER | 263722257 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $4100.00 | 1386161495 - MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC | 820985178 - (MD) MEDSTAR SURGERY CENTER AT BRAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $500.00 | 1396852570 - EAGLE PHYSICIANS AND ASSOCIATES PA, EAGLE ENDOSCOPY CENTER | 561847193 - EAGLE PHYSICIANS & ASSOCIATES, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43770 | $3663.00 | 1942231493 - TAYLOR STATION SURGICAL CENTER LTD | 311459910 - (OH) TAYLOR STATION SURGICAL CENTER | OH | 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 43770 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43770 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 43770 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 |
|---|---|---|
| 43770-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; Placement Of Adjustable Gastric Restrictive Device (Eg, Gastric Band And Subcutaneous Port Components) |
| 43771-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; Revision Of Adjustable Gastric Restrictive Device Component Only- Rn Review |
| 43772-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; Removal Of Adjustable Gastric Restrictive Device Component Only -Medicaid Rn Review: Comm Rn Review=1/1/2006-3/27/2023 |
| 43773-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; Removal & Replacement Of Adjustable Gastric Restrictive Device -Medicaid Rn Review: Comm Rn Review=1/1/2006-3/27/2023 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43770. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43770 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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