CPT code 43332: Hiatal hernia repair, open, without fundoplasty2026 Medicare rate & RVUs in Texas
Reports open abdominal repair of a paraesophageal hiatal hernia when the operation does not include fundoplasty or mesh implantation.
CMS doesn’t publish an office rate for 43332 in Texas.
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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What 43332 covers
This code describes an open abdominal operation to repair a paraesophageal hiatal hernia. The surgeon brings herniated stomach or other displaced contents back into the abdomen and repairs the enlarged opening in the diaphragm. General and foregut surgeons commonly perform the procedure in a hospital operating room. The code distinguishes a repair performed without fundoplasty and without mesh from related approaches and repairs that include those features.
Report the code when the operative report supports the transabdominal approach and confirms that neither fundoplasty nor mesh implantation was performed. Documentation should describe the hernia repair and the operative approach; use a related code when the operation includes a different approach, fundoplasty, or mesh. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure setting, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this repair.
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 43332 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,076.55 |
| Beaumont, TX | Unavailable | $1,041.44 |
| Brazoria, TX | Unavailable | $1,044.62 |
| Dallas, TX | Unavailable | $1,059.35 |
| Fort Worth, TX | Unavailable | $1,058.71 |
| Galveston, TX | Unavailable | $1,052.99 |
| Houston, TX | Unavailable | $1,142.31 |
| Rest of Texas | Unavailable | $1,047.97 |
How the 43332 rate is calculated
Each of 43332’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 · 43332
RVUs × geographic indexes × conversion factor
Work19.13
19.13 RVUs× 1.000 GPCI
Practice expense8.26
8.26 RVUs× 1.000 GPCI
Malpractice4.88
4.88 RVUs× 1.000 GPCI
Adjusted RVUs
32.2700
Conversion factor
$33.4009
Medicare rate
$1,077.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43332
43332 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43332
Hiatal hernia repair, open, without fundoplasty
| 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 · 43332
Hiatal hernia repair, open, without fundoplasty
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
43332 without 51 · national facility
$1,077.85
Hiatal hernia repair, open, without fundoplasty
43332-51 · Second procedure: 50%
$538.93
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%).
43332 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43333Hernia repairTransabdominal, with mesh
- Choose 43333 rather than 43332 when fundoplasty is performed during the open transabdominal repair; both codes describe repairs without mesh.
- 43334Diaphragmatic hernia repairTransthoracic, without prosthesis
- 43334 identifies a transthoracic repair without fundoplasty or mesh. 43332 identifies the transabdominal approach.
- 43281Hernia repairLaparoscopic, without mesh
- 43281 is the laparoscopic alternative for paraesophageal hernia repair without mesh; 43332 is for an open transabdominal operation.
- 43282Hernia repairLaparoscopic, with mesh
- 43282 describes laparoscopic paraesophageal hernia repair with mesh implantation. 43332 describes an open abdominal repair without mesh.
43332 billing questions
How does 43332 differ from 43333?
43332 is for the open transabdominal repair without fundoplasty or mesh. Use 43333 when the repair includes fundoplasty and does not include mesh.
Can 43332 be used for a laparoscopic repair?
No. It identifies an open transabdominal approach. Laparoscopic paraesophageal hernia repair is represented by a different code family.
What operative details should the record support?
Document the paraesophageal hernia repair, the transabdominal approach, and whether fundoplasty or mesh was performed. Those details distinguish this code from related repair options.
Does modifier 50 apply when the hernia involves both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included in the global period?
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 paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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