CPT 43772 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 • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 43772 |
National average reimbursement for CPT 43772 by major payers:
$1,233.70
$1,278.73
$1,350.72
$1,567.29
| 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 43772 | ||||||
United | 43772 | $8000.00 | 1194264036 - ADVANCED SURGICAL CENTER, LLC | 475144859 - (TX) ADVANCED SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $8815.00 | 1477516961 - CENTRUM SURGERY CENTER LTD | 752546712 - (CO) CENTRUM SURGERY CENTER LTD | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $1290.00 | 1285874065 - WEST CHASE SURGERY CENTER LTD | 260167338 - (FL) WEST CHASE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $2424.00 | 1477047199 - PAIN & SPINE PHYSICIANS SURGERY CENTER LLC | 821654725 - (GA) PAIN SPINE PHYSICIANS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $3060.00 | 1285980151 - PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN, LLC, GOOD SAMARITAN SURGERY CENTER | 270573717 - (IL) PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $1699.00 | 1841711942 - MACON VASCULAR CARE, LLC | 320415161 - (GA) MACON VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $3570.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $651.00 | 1588797807 - SPOKANE DIGESTIVE DISEASE CENTER, P.S., SOUTH ASC | 911013238 - (WA) SPOKANE DIGESTIVE DISEASE CENTER P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $631.00 | 1396260931 - COLORECTAL SURGICAL & GASTROENTEROLOGY ASSOCIATES PSC, CSGA SURGERY CENTER | 611171052 - (KY) COLORECTAL SURGICAL & GASTROENTEROLOGY ASSOCIATES PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $1854.00 | 1992384739 - SURGERY CENTER OPERATIONS, LLC | 851921698 - (FL) SURGERY CENTER OPERATIONS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $673.00 | 1386885556 - THE ASC AT WAUGH CHAPEL | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $2688.00 | 1710768783 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, ATLAS SURGERY CENTER | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $3570.00 | 1891175188 - PHOENIX SPINE GOODYEAR ASC, LLC, PHOENIX SPINE SURGERY CENTER | 562311366 - (AZ) PHOENIX SPINE GOODYEAR, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $2637.00 | 1922076959 - BAPTIST HEALTH SURGERY CENTER LLC, BAPTIST HEALTH SURGERY CENTER AT KENDALL | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43772 | $1890.00 | 1700492170 - MERCY HEALTH BOARDMAN SURGERY | 863462441 - (OH) BSMH AMBULATORY VENTURES II LLC | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 43772 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43772 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 43772 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 43772. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43772 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 43772) and we'll show you how you compare in 15 minutes or less.