CPT 43771 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 • AS - PA/NP/CNS assistant at surgery • AG - Primary physician • 80 - Assistant surgeon • LL • NU |
| Complexity Level | High |
| CMS | $1,249.55 Physician Fee Schedule |
National average reimbursement for CPT 43771 by major payers:
$1,682.99
$1,703.99
$1,775.13
$2,097.97
| 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 43771 | ||||||
United | 43771 | $1739.00 | 1275522849 - COLIMA ENDOSCOPY CENTER INC, COLIMA ENDOSCOPY CENTER | 954611492 - (CA) COLIMA ENDOSCOPY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $1672.00 | 1073546875 - STRAND GASTROINTESTINAL ENDOSCOPY CENTER | 571082826 - (SC) STRAND GASTROINTESTINAL ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $1063.00 | 1407223019 - VALLEY OUTPATIENT SERVICES, LLC | 474866031 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $3500.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $939.00 | 1821459496 - GEM STATE ENDOSCOPY | 352553021 - (ID) GEM STATE ENDOSCOPY | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $2703.00 | 1518311141 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $1750.00 | 1912447418 - LUBBOCK SURGERY CENTER, LLC | 812766547 - (TX) LUBBOCK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $956.00 | 1164414447 - EAST VALLEY ENDOSCOPY LLC | 870667809 - (AZ) EAST VALLEY ENDOSCOPY, PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $675.00 | 1386602332 - THREE RIVERS ENDOSCOPY CENTER, INC. | 251788887 - (PA) THREE RIVERS ENDOSCOPY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $1500.00 | 1285825075 - SUNNYSIDE SURGERY CENTER, LLC | 201164055 - (ID) SUNNYSIDE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $720.00 | 1376748228 - FLORIDA SPECIALTY SURGERY CENTER LLC | 203672687 - (FL) FLORIDA SPECIALTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $1189.00 | 1053505511 - DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC | 260531425 - (NY) DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $2555.00 | 1740823848 - KING OF PRUSSIA SURGERY CENTER, LLC, KING OF PRUSSIA SURGERY CENTER | 832782091 - (PA) KING OF PRUSSIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $6290.00 | 1417922915 - FRANCONIA-SPRINGFIELD SURGERY CENTER, LLC, INOVA SURGERY CENTER @ FRANCONIA-SPRINGFIELD | 542018390 - (VA) INOVA AMBULATORY SURGICAL CENTERS | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43771 | $3623.00 | 1356764484 - BLOOMINGTON ASC, LLC, INDIANA SPECIALTY SURGERY CENTER | 364775143 | IN | 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 43771 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43771 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 43771 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 43771. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43771 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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