CPT 43520
Incision of pyloric muscle
CPT 43520 at a glance
- Code
- 43520
- Code type
- CPT/HCPCS (Add. EE)
- Short descriptor
- Incision of pyloric muscle
- Category
- Excluded from ASC Pay (Add. EE)
- ASC payment status
- Excluded from ASC payment
- CMS addendum
- EE (Excluded)
- Typical setting
- Hospital outpatient department (POS 22) or office (POS 11). Not separately payable in an ASC.
What is CPT code 43520?
CPT 43520 is a CPT/HCPCS (Add. EE) procedure code. Its official CMS short descriptor is "Incision of pyloric muscle". In the ASC context it is grouped under Excluded from ASC Pay (Add. EE).
Is CPT 43520 payable in an ambulatory surgery center (ASC)?
CPT 43520 is on CMS Addendum EE, the list of procedures excluded from ASC payment. Medicare does not pay for it in the ASC setting; it is typically performed in a hospital outpatient department (HOPD) or office instead.
Where is CPT 43520 typically performed?
Hospital outpatient department (POS 22) or office (POS 11). Not separately payable in an ASC.
Which specialties use CPT 43520?
CPT 43520 is most associated with Gastroenterology, General Surgery.
Reference information compiled from the CMS April 2026 ASC payment addenda (AA, BB, EE). Codes, descriptors, and ASC payment status change with each CMS update. This is a coding reference, not billing, coding, or legal advice. Always verify against the current CMS addenda and individual payer policy before billing. CPT is a registered trademark of the American Medical Association.