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See a sample rate comparisonCPT 43820 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.
Gastrojejunostomy
| 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 | 51 - Multiple procedures GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $1,256.54 national non-facility rate (2026) · View Medicare rates for 43820 |
| Medicaid Fee Schedule | $975.725 median of the 8 states in the free preview · View Medicaid rates for 43820 |
National average reimbursement for CPT 43820 by major payers:
$1,597.24
$1,743.95
$1,923.58
$2,100.70
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CPT 43820
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Port Charlotte Ltd
$2,732.00Published rateColorado Urologic Surgery Center LLC
$1,064.00Published rateDeer Pointe Surgical Center, LLC, Poa Surgery Center
Deer Pointe Surgical Center, LLC
$758.00Published rateLouisville Endoscopy Center, PLLC, Louisville Endoscopy Center
Louisville Endoscopy Center PLLC
$492.00Published rateKramberg Obs
$100.00Published rate
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See a sample payer proposalCPT 43820 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43820 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 43820 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 |
|---|---|---|
| 43800-CPT | High | Widen Stomach Opening To Bowel, Surgery To Widen The Opening Of The Bottom Of The Stomach By Cutting The Muscles At The Junction Between The Stomach And The Small Intestine. |
| 43810-CPT | High | Gastroduodenostomy |
| 43820-CPT | High | Gastrojejunostomy |
| 43825-CPT | High | Gastrojejunostomy W Vagotomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43820 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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