CPT 43773 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 |
| CMS | $1,249.55 Physician Fee Schedule |
National average reimbursement for CPT 43773 by major payers:
$1,834.59
$1,704.35
$1,832.18
$2,098.36
| 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 43773 | ||||||
United | 43773 | $2223.00 | 1760860977 - MID MISSOURI SURGERY CENTER, LLC, SURGERY CENTER AT THE FORUM | 464006663 - (MO) MID-MISSOURI SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $9241.00 | 1780853044 - HACIENDA SURGERY CENTER, LLC | 320439356 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $1374.00 | 1811932270 - PHILADELPHIA SURGI CENTER, INC. | 232965126 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $383.00 | 1629262811 - PREMIER ENDOSCOPY CENTER LLC | 205055187 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $830.00 | 1184897472 - LAKE COUNTRY ENDOSCOPY CENTER, LLC | 261572986 - (WI) LAKE COUNTRY ENDOSCOPY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $5249.00 | 1245427228 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $1898.00 | 1609871680 - LAUREL MD ENDOSCOPY ASC LLC, AMBULATORY ENDOSCOPY CENTER OF MARYLAND | 203959465 - (MD) LAUREL MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $4629.02 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $835.00 | 1043411648 - COFFEE COUNTY CENTER FOR DIGESTIVE DISEASES LLC | 562402712 - (GA) COFFEE COUNTY CENTER FOR DIGESTIVE DISEASES LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $1869.00 | 1598815110 - EXECUTIVE ENDOSCOPY, INC., ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $1440.00 | 1629038989 - SAN ANTONIO EYE CENTER, PA, SAN ANTONIO EYE SURGICENTER | 741916103 - (TX) SAN ANTONIO EYE CENTER, PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $5433.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $1900.00 | 1801844386 - SOUTHEASTERN UROLOGICAL PARTNERS LTD, SOUTHEASTERN SURGERY CENTER | 593470900 - (FL) SOUTHEASTERN UROLOGICAL PARTNERS, LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $1753.00 | 1467721332 - CAPITAL SURGERY AND LASER CENTER, LLC | 800674445 - (PA) CAPITAL SURGERY AND LASER CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43773 | $2790.00 | 1407023161 - SOUTHWEST MINNESOTA SURGICAL CENTER, INC. | 261451498 - (MN) SOUTHWEST MINNESOTA SURGICAL CENTER INC | MN | 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 43773 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43773 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 43773 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 43773. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43773 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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