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See a sample rate comparisonCPT 43774 Fee Schedule
Last Verified: October 2026
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.
Surgery To Remove Stomach Band, Surgery Aided By A Scope (Laparoscope) To Remove An Adjustable Band Placed Around The Stomach. Access Ports That May Have Been Placed Under The Skin Also Are Removed At This Time.
| 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 | AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | $907.50 national non-facility rate (2026) · View Medicare rates for 43774 |
| Medicaid Fee Schedule | $703.315 median of the 8 states in the free preview · View Medicaid rates for 43774 |
National average reimbursement for CPT 43774 by major payers:
$1,215.61
$1,289.07
$1,376.97
$1,551.05
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CPT 43774
5 of 25 sample ratesHigher to lower in this preview
Eye Surgery Center Of Georgia, LLC
Eye Surgery Center Of Georgia LLC
$16,259.00Published rateEndoscopy Asc Of Middle Georgia LLC
$9,510.00Published rateSpecialty Surgical Center, LLC, Specialty Surgical Center
Specialty Surgical Center, LLC
$7,700.00Published rateSouth Jersey Endoscopy LLC, Dimarino-Kroop-Prieto Gi Assoc
South Jersey Endoscopy LLC
$3,017.00Published rateDavid Sandage
Deaconess Hospital Inc
$761.09Published rate
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See a sample payer proposalCPT 43774 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43774 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 43774 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, Laparoscopy Surgical Gastric Restrictive Procedure Placement Of Adjustable Gastric Restrictive Device (E.G. Gastric Band And Subcutaneous Port Components) |
| 43771-CPT | High | Stomach Band Adjustment, Surgery Aided By A Scope (Laparoscope) To Adjust The Location Or Sizing Of A Restrictive Band Placed Around The Upper Stomach. |
| 43772-CPT | High | Surgery To Remove Stomach Band, Surgery Aided By A Scope (Laparoscope) To Remove An Adjustable Band Placed Around The Stomach. Access Ports That May Have Been Placed Under The Skin Also Are Removed At This Time. |
| 43774-CPT | High | Surgery To Remove Stomach Band, Surgery Aided By A Scope (Laparoscope) To Remove An Adjustable Band Placed Around The Stomach. Access Ports That May Have Been Placed Under The Skin Also Are Removed At This Time. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43774. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43774 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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