CPT 43887 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $329.61 Physician Fee Schedule |
National average reimbursement for CPT 43887 by major payers:
$414.86
$435.55
$458.22
$554.61
| 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 43887 | ||||||
United | 43887 | $2499.00 | 1083754352 - MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA, MERCY PHILADELPHIA HOSPITAL SHORT PROCEDURE UNIT | 231352191 - (PA) MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $853.00 | 1003374711 - RIVERVIEW SURGICAL CENTER LLC | 821368525 - (NE) RIVERVIEW SURGICAL CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $446.00 | 1487824173 - SEASCAPE SURGERY CENTER LLC | 800150187 - (FL) SEASCAPE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $1368.00 | 1134182660 - CORAL SPRINGS SURGI-CENTER LTD | 650538147 - (FL) CORAL SPRINGS SURGICENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $419.00 | 1417903899 - JUPITER OUTPATIENT SURGERY CENTER LLC | 650925020 - (FL) JUPITER OUTPATIENT SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $850.00 | 1134779622 - HELIX SURGICENTER LLC | 834455797 - (IN) HELIX SURGICENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $536.00 | 1740529064 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $785.00 | 1639431653 - DESERT CLIFFS SURGERY CENTER LLC | 800824134 - (AZ) DESERT CLIFFS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $303.00 | 1598965634 - LAKE CITY SURGERY CENTER, LLC | 260811545 - (FL) LAKE CITY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $2480.00 | 1508837899 - MEMORIAL HERMANN SURGERY CENTER NORTHWEST, LLP, MEMORIAL HERMANN SURGERY CENTER GREATER HEIGHTS | 200689650 - (TX) MEMORIAL HERMANN SURGERY CENTER NORTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $426.00 | 1760770903 - ASSOCIATED SURGICAL CENTER OF DEARBORN LLC | 275209399 - (MI) ASSOCIATED SURGICAL CENTER OF DEARBORN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $1722.00 | 1538262118 - MERCURY SURGERY CENTER LLC | 202045960 - (MO) MERCURY SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $376.00 | 1255446910 - DOWNTOWN BALTIMORE SURGERY CENTER, LLC | 522219532 - (MD) DOWNTOWN BALTIMORE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $997.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 43887 | $489.00 | 1104866904 - SOUTHWESTERN EYE CENTER, SOUTHWESTERN EYE SURGICENTER-SHOW LOW | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | 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 43887 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43887 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 43887 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 Restrictive Procedure; Placement Of Adjustable Gastric Restrictive Device (Eg, Gastric Band And Subcutaneous Port Components) |
| 43771-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; Revision Of Adjustable Gastric Restrictive Device Component Only- Rn Review |
| 43772-CPT | High | Laparoscopy, Surgical, Gastric Restrictive Procedure; Removal Of Adjustable Gastric Restrictive Device Component Only -Medicaid Rn Review: Comm Rn Review=1/1/2006-3/27/2023 |
| 43887-CPT | Moderate | Gastric Restrictive Procedure, Open; Removal Of Subcutaneous Port Component Only -Medicaid Rn Review: Comm Rn Review=1/1/2006-3/27/2023 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43887. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43887 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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