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See a sample rate comparisonCPT 43775 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.
Weight Loss Surgery, Surgery Aided By A Scope (Laparoscope) To Remove A Portion Of The Stomach (Gastric Sleeve Surgery). The Procedure Is Done To Help Weight Loss.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | AS - PA/NP/CNS assistant at surgery 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | $1,000.02 national non-facility rate (2026) · View Medicare rates for 43775 |
| Medicaid Fee Schedule | $773.205 median of the 8 states in the free preview · View Medicaid rates for 43775 |
National average reimbursement for CPT 43775 by major payers:
$1,647.82
$1,626.28
$1,701.99
$1,882.87
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CPT 43775
5 of 25 sample ratesHigher to lower in this preview
Children'S Hospital
Childrens Hospital Inc
$15,902.00Published rateAdvanced Surgery Center Of San Antonio, LLC
$4,150.00Published rateCharles Yu
$2,844.52Published rateJoseph Finstein
Pontchartrain Bone And Joint Clinic, Ltd
$1,678.08Published rateSeth Rosenzweig
Abbeville General Hospital
$1,093.16Published rate
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See a sample payer proposalCPT 43775 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43775 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 43775 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. |
| 43775-CPT | High | Weight Loss Surgery, Surgery Aided By A Scope (Laparoscope) To Remove A Portion Of The Stomach (Gastric Sleeve Surgery). The Procedure Is Done To Help Weight Loss. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43775. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43775 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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Frequently Asked Questions
To get an estimate for the cost of a specific medical procedure or service, you can use specialized tools. We recommend using Payerprice, which offers a fee schedule lookup tool. You can search by the CPT code for the service and your specific location to get relevant pricing information. For the most accurate personalized estimate, always contact your healthcare provider and insurance company directly, as your out-of-pocket costs will depend on your individual insurance plan.
A CPT (Current Procedural Terminology) code is a five-digit numeric code used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. These codes are crucial for billing and for tools like Payerprice to accurately identify and provide pricing information for specific services. Knowing the CPT code for your procedure can help you get more precise cost estimates.
Healthcare costs can be confusing due to complex factors like varying negotiated rates between providers and insurers, geographic differences, and the multitude of services that can be part of a single treatment. Payerprice helps bring transparency by allowing you to look up fee schedules for specific CPT codes and locations, giving you a clearer idea of potential costs before you receive care. This can empower you to make more informed decisions.
Payerprice provides fee schedule information, which reflects the general cost of a service based on CPT code and location. While this is a vital step in understanding potential expenses, it does not directly show your exact out-of-pocket costs. Your final out-of-pocket amount will depend on your specific health insurance plan, including factors like your deductible, co-pays, and co-insurance. For a precise calculation of your out-of-pocket responsibility, you should always consult your insurance provider.
To use Payerprice's fee schedule lookup tool, you will typically need to know the CPT (Current Procedural Terminology) code for the medical service or procedure you are interested in. Once you have the CPT code, you can input it along with your specific geographic location into the Payerprice search tool to retrieve relevant pricing information and fee schedules for that service.