CPT 43848 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 80 - Assistant surgeon • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| CMS | $1,884.83 Physician Fee Schedule |
National average reimbursement for CPT 43848 by major payers:
$2,423.44
$2,574.31
$2,661.25
$3,131.58
| 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 43848 | ||||||
United | 43848 | $445.00 | 1487090452 - DIGESTIVE HEALTH SPECIALISTS, PA | 561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $580.00 | 1326170036 - TAMPA BAY EYE SURGERY CENTER, LLC | 273286942 - (FL) TAMPA BAY EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $773.00 | 1215126438 - THE ARCADIA CA ENDOSCOPY ASC LP, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $1500.00 | 1518057546 - LONG ISLAND AMBULATORY SURGERY CENTER, LLC | 200369668 - (NY) LONG ISLAND AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $560.00 | 1043560295 - CENTENNIAL SPECIALTY SURGERY CENTER INC | 454699837 - (NV) CENTENNIAL SPECIALTY SURGERY CENTER INC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $3500.00 | 1619972791 - AMBULATORY SURGERY CENTER OF SPARTANBURG, LLC | 571128350 - (SC) AMBULATORY SURGERY CENTER OF SPARTANBURG | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $592.00 | 1447991138 - SILVER STATE SURGERY CENTER WEST LLC | 872764352 - (NV) SILVER STATE SURGERY CENTER WEST LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $980.00 | 1205845740 - THE UROLOGY CENTER LLC | 311579733 - (OH) THE UROLOGY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $448.00 | 1356646715 - ZACHARY ASC PARTNERS, LLC, ZACHARY ASC PARTNERS, LLC | 273854435 - (LA) ZACHARY ASC PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $1055.69 | 1417944778 - MERRIMACK VALLEY ENDOSCOPY CENTER | 43578297 - (MA) MERRIMACK VALLEY ENDOSCOPY CENTER | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $583.00 | 1962580266 - NOVAMED SURGERY CENTER OF WARRENSBURG LLC, EYE SURGERY CENTER OF WARRENSBURG | 205698307 - (MO) NOVAMED SURGERY CENTER OF WARRENSBURG LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $750.00 | 1053328781 - LOS ALAMITOS SURGERY CENTER L P | 550823348 - (CA) LOS ALAMITOS SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $492.00 | 1700828423 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $984.00 | 1982238465 - PROFESSIONAL RECREATION ORGANIZATION, INC. | 931484998 - (WA) PRO SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43848 | $425.00 | 1598952061 - ENDOSCOPY ASSOCIATES, LLC | 142006705 - (VA) ENDOSCOPY ASSOCIATES LLC | VA | 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 43848 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43848 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 43848 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 |
|---|---|---|
| 43842-CPT | High | Gastric Restrictive Procedure, Without Gastric Bypass, For Morbid Obesity; Vertical-Banded Gastroplasty -Medicaid Rn Review: Comm Rn Review=1/1/1996-3/27/2023 |
| 43843-CPT | High | Gastric Restrictive Procedure, Without Gastric Bypass, For Morbid Obesity; Other Than Vertical-Banded Gastroplasty -Medicaid Rn Review: Comm Rn Review=1/1/1996-3/27/2023 |
| 43845-CPT | High | Gastric Restrictive Procedure With Partial Gastrectomy, Pylorus-Preserving Duodenoileostomy And Ileoileostomy (50 To 100 Cm Common Channel) To Limit Absorption (Biliopancreatic Diversion With Duodenal Switch) |
| 43848-CPT | High | Revision, Open, Of Gastric Restrictive Procedure For Morbid Obesity, Other Than Adjustable Gastric Restrictive Device -Medicaid Rn Review: Comm Rn Review=1/1/1995-3/27/2023 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43848. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43848 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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