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See a sample rate comparisonCPT 43880 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.
Closure Of Gastrocolic Fistula
| 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 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $1,496.69 national non-facility rate (2026) · View Medicare rates for 43880 |
| Medicaid Fee Schedule | $1,164.25 median of the 8 states in the free preview · View Medicaid rates for 43880 |
National average reimbursement for CPT 43880 by major payers:
$1,943.53
$2,121.50
$2,189.18
$2,529.54
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CPT 43880
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Stephenville
$11,727.00Published rateSurgcenter Camelback LLC
$1,049.00Published rateSurgicare Of La Veta Inc., Barranca Surgery Center
$712.00Published rateBarnet Dulaney Perkins Eye Center, PC, Bdpec Showlow
Barnet Dulaney Perkins Eye Center PLLC
$492.00Published rateNorthland Eye Surgery Center, LLC
$66.00Published rate
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See a sample payer proposalCPT 43880 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43880 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 43880 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 |
|---|---|---|
| 43830-CPT | Moderate | Gastrostomy Open; W/O Construct Of Gastric Tube (Eg Stamm Pro, Gastrostomy Open; Without Construction Of Gastric Tube (Eg Stamm Pro |
| 43880-CPT | High | Closure Of Gastrocolic Fistula |
| 43881-CPT | High | Surgery For Nausea Control, Surgery To Implant A Device In The Stomach That Produces Mild Electrical Impulses To Treat Nausea And Vomiting. |
| 43882-CPT | High | Revisn Or Remval Of Gastric Neurostimula Electrdes Antrum Ope, Revision Or Removal Of Gastric Neurostimulator Electrodes Antrum Ope |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43880. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43880 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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