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 | $1514.00 | 1003233180 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, DIALYSIS CENTER AT VALLEYWISE COMPREHENSIVE CARE CENTER - PHOENIX | 860830701 | AZ | End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X) |
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 | $1789.28 | 1306890942 - BROOKS COUNTY HOSPITAL | 586002830 | GA | Critical Access Hospital (282NC0060X) |
United | G0343 | $1778.00 | 1740981430 - NORTHEAST GEORGIA MEDICAL CENTER HABERSHAM LLC | 922451946 | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $1676.57 | 1861478851 - CLINCH COUNTY HOSPITAL AUTHORITY | 586011853 - (GA) CLINCH COUNTY HOSPITAL AUTHORITY | GA | Critical Access Hospital (282NC0060X) |
United | G0343 | $1676.57 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | G0343 | $2807.88 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $6532.00 | 1619997079 - WELLSTAR SYLVAN GROVE HOSPITAL, INC, WELLSTAR SYLVAN GROVE HOSPITAL | 810875069 - (GA) WELLSTAR SYLVAN GROVE HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | G0343 | $13097.00 | 1093009151 - USC UNIVERSITY HOSPITAL | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | G0343 | $3493.00 | 1467406132 - EASTSIDE MEDICAL CENTER, LLC, PIEDMONT EASTSIDE MEDICAL CENTER | 582433432 | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $3251.21 | 1396923710 - EMORY UNIVERSITY HOSPITAL | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $2592.00 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | G0343 | $16586.00 | 1417554528 - KECK MEDICAL CENTER OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | G0343 | $13097.00 | 1952546616 - UNIVERSITY OF SOUTHERN CALIFORNIA, KECK HOSPITAL OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | G0343 | $2946.31 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | 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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