CPT code 43327: Fundoplasty, laparoscopic approach2026 Medicare rate & RVUs in Missouri
Reports laparoscopic wrapping of the stomach fundus around the distal esophagus as an antireflux operation, such as a Nissen or Toupet procedure.
CMS doesn’t publish an office rate for 43327 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 43327 covers
The surgeon uses laparoscopic access to mobilize the stomach fundus and wrap it around the lower esophagus, reinforcing the barrier against reflux. A complete Nissen wrap and a partial Toupet wrap are familiar examples. General or foregut surgeons typically perform the operation in a hospital operating room for patients undergoing surgical treatment of gastroesophageal reflux; it may also be part of an operation addressing a hiatal hernia.
Select this code when the operative report supports laparoscopic fundoplasty, rather than an open or thoracic approach. Documentation should describe the approach and the fundal wrap performed; record any associated hernia work so the applicable code selection can be evaluated. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 43327 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $773.93 |
| Metropolitan St. Louis, MO | Unavailable | $779.96 |
| Rest of Missouri | Unavailable | $755.07 |
How the 43327 rate is calculated
Each of 43327’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43327
RVUs × geographic indexes × conversion factor
Work13.02
13.02 RVUs× 1.000 GPCI
Practice expense7.20
7.20 RVUs× 1.000 GPCI
Malpractice3.47
3.47 RVUs× 1.000 GPCI
Adjusted RVUs
23.6900
Conversion factor
$33.4009
Medicare rate
$791.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43327
43327 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43327
Fundoplasty, laparoscopic approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43327
Fundoplasty, laparoscopic approach
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43327 without 51 · national facility
$791.27
Fundoplasty, laparoscopic approach
43327-51 · Second procedure: 50%
$395.64
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43327 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43320Esophageal reconstructionStomach connection
- Both describe esophagogastric fundoplasty. Code 43327 is selected for the laparoscopic approach; code 43320 is the related nonlaparoscopic service.
- 43325Anastomosis revisionAbdominal approach
- This related fundoplasty code identifies a service involving hiatal hernia repair. Use the code whose descriptor matches the operative work, rather than choosing by the wrap alone.
- 43328FundoplastyThoracic approach
- Both are fundoplasty procedures, but 43328 uses a thoracic approach; 43327 identifies laparoscopic access.
43327 billing questions
How does this differ from code 43328?
Code 43327 describes the laparoscopic approach. Code 43328 is the thoracic-approach fundoplasty; the operative report should establish which route the surgeon used.
When should I compare this with code 43320?
Both describe esophagogastric fundoplasty, but 43327 identifies laparoscopic access. Review the documented approach before selecting between them.
Does a hiatal hernia repair change code selection?
Document the hernia repair and the fundoplasty performed. Compare the operative service with the applicable fundoplasty code, including 43325 when its descriptor fits the documented work.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other same-session procedures paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction when performed in the same session.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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