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See a sample rate comparisonCPT 43825 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 W Vagotomy
| 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 | 80 - Assistant surgeon AS - PA/NP/CNS assistant at surgery 58 - Staged or related procedure during postoperative period AG - Primary physician GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $1,230.49 national non-facility rate (2026) · View Medicare rates for 43825 |
| Medicaid Fee Schedule | $958.31 median of the 8 states in the free preview · View Medicaid rates for 43825 |
National average reimbursement for CPT 43825 by major payers:
$1,592.55
$1,733.92
$1,803.71
$2,072.86
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CPT 43825
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Stephenville
$11,727.00Published rateAdventhealth Surgery Center Wellswood LLC, Adventhealth Surgery Center Wellswood
Adventhealth Surgery Center Wellswood LLC
$983.00Published rateRenaissance Surgery Center Of Chattanooga, LLC
Renaissance Surgery Center Of Chattanooga LLC
$582.00Published rateApex Ambulatory Surgery Center Inc
$470.00Published rateJeffrey L Bober Dpm PA, Jeffrey L Bober Dpm PA Asc
Jeffrey L Bober Dpm PA
$158.00Published rate
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See a sample payer proposalCPT 43825 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43825 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 43825 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 |
|---|---|---|
| 43820-CPT | High | Gastrojejunostomy |
| 43825-CPT | High | Gastrojejunostomy W Vagotomy |
| 43830-CPT | Moderate | Gastrostomy Open; W/O Construct Of Gastric Tube (Eg Stamm Pro, Gastrostomy Open; Without Construction Of Gastric Tube (Eg Stamm Pro |
| 43840-CPT | High | Gstrorrhaphy Suture Of Perforat Duodenal Or Gastric Ulcer Wound, Gastrorrhaphy Suture Of Perforated Duodenal Or Gastric Ulcer Wound |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43825. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43825 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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