CPT code 43620: Total gastrectomy, esophagoenterostomy reconstruction2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 43620 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 43620 covers

This code describes open removal of the entire stomach followed by a connection between the esophagus and small intestine. A general surgeon or surgical oncologist may perform it for gastric cancer or other extensive gastric disease when the operative plan calls for total rather than partial removal. The reconstruction is part of the service, not a separate intestinal procedure.

Select the code when the operative report supports removal of the whole stomach and the specified esophagoenterostomy reconstruction; a partial resection or a different reconstruction points to another code. Documentation should identify the extent of resection and the reconstruction performed. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate. 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 43620 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 43620 rate is calculated

Each of 43620’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.

Payment rules and modifiers for 43620

43620 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

43620 compared with similar codes

How to choose

43621Total gastrectomyRoux-en-Y reconstruction

Both codes describe total gastrectomy, but the reconstruction differs. Use 43620 for esophagoenterostomy and select 43621 when its distinct reconstruction matches the operative report.

43622Total gastrectomyRoux-en-Y reconstruction

43622 is a separate total gastrectomy variant. Choose between the codes based on the specific reconstruction and operative details required by the full descriptor.

43631Partial gastrectomyDistal, gastroduodenostomy

43631 describes partial distal stomach removal with reconstruction, not removal of the entire stomach. The extent of resection determines which code applies.

Codes related to 43620

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates