HCPCS G0343 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 | • Procedures / Professional Services • Miscellaneous Diagnostic and Therapeutic Services |
| Complexity Level | High |
National average reimbursement for HCPCS G0343 by major payers:
$1,407.82
$1,540.49
$1,224.33
$1,285.87
| 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 HCPCS G0343 | ||||||
United | G0343 | $3493.00 | 1467406132 - EASTSIDE MEDICAL CENTER, LLC, PIEDMONT EASTSIDE MEDICAL CENTER | 582433432 | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $1514.00 | 1427476670 - MARICOPA COUNTY SPECIAL HEALTHCARE DISTRICT, MARICOPA INTEGRATED HEALTH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | G0343 | $1762.00 | 1295154045 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | G0343 | $1513.61 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $2250.72 | 1790888089 - HOSPITAL AUTHORITY OF CANDLER COUNTY, CANDLER COUNTY HOSPITAL | 586004640 | GA | Critical Access Hospital (282NC0060X) |
United | G0343 | $2660.34 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | G0343 | $2236.60 | 1700830247 - HOSPITAL AUTHORITY OF MITCHELL COUNTY, MITCHELL COUNTY HOSPITAL | 586001307 - (GA) HOSPITAL AUTHORITY OF MITCHELL COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | G0343 | $1762.00 | 1104331115 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE CHC - MESA BEHAVIORAL HEALTH SPECIALTY CLINIC | 860830701 | AZ | Adult Mental Health Clinic/Center (261QM0850X) |
United | G0343 | $1762.00 | 1114346962 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, MARICOPA INTEGRATED HEALTH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | G0343 | $1997.04 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 814817422 | GA | Rural Acute Care Hospital (282NR1301X) |
United | G0343 | $1514.00 | 1891114641 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | Federally Qualified Health Center (FQHC) (261QF0400X) |
United | G0343 | $1291.58 | 1417157405 - EMORY HEALTHCARE | 711018941 - CARDIAC ARRHYTHMIA INSTITUTE | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $2386.73 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $1762.00 | 1770167108 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT | 860830701 | AZ | Multi-Specialty Clinic/Center (261QM1300X) |
United | G0343 | $3032.85 | 1710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL | 581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE | GA | General Acute Care Hospital (282N00000X) |
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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HCPCS G0343 vs. Other Miscellaneous Diagnostic and Therapeutic Services Codes
The HCPCS G0343 code is part of the Procedures / Professional Services services used for Miscellaneous Diagnostic and Therapeutic Services. 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 HCPCS G0343 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 |
|---|---|---|
| G0342-HCPCS | Moderate | Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion |
| G0343-HCPCS | High | Laparotomy for islet cell transplant, includes portal vein catheterization and infusion |
| G0372-HCPCS | Low | Physician service required to establish and document the need for a power mobility device |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0343. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0343 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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