CPT code 43633: Partial gastrectomy, distal, Roux-en-Y reconstruction2026 Medicare rate & RVUs in Missouri
Reports removal of the distal stomach with Roux-en-Y reconstruction, when the operative plan reconnects the remaining stomach to a jejunal limb.
CMS doesn’t publish an office rate for 43633 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 43633 covers
The surgeon removes the distal portion of the stomach and restores continuity by connecting the gastric remnant to a Roux limb of the jejunum. This operation may be performed for gastric cancer or other conditions requiring distal stomach resection. It is typically performed by a general or gastrointestinal surgeon in an operating room, often in a hospital setting.
Select this code from the operative report’s resection extent and reconstruction, not diagnosis alone; documentation should identify the portion removed and the Roux-en-Y configuration. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this stomach procedure. An assistant at surgery may be paid; co-surgeons require 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 43633 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 | $1,743.84 |
| Metropolitan St. Louis, MO | Unavailable | $1,756.19 |
| Rest of Missouri | Unavailable | $1,710.49 |
How the 43633 rate is calculated
Each of 43633’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 · 43633
RVUs × geographic indexes × conversion factor
Work32.31
32.31 RVUs× 1.000 GPCI
Practice expense12.65
12.65 RVUs× 1.000 GPCI
Malpractice8.21
8.21 RVUs× 1.000 GPCI
Adjusted RVUs
53.1700
Conversion factor
$33.4009
Medicare rate
$1,775.93
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43633
43633 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43633
Partial gastrectomy, distal, Roux-en-Y reconstruction
| 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 · 43633
Partial gastrectomy, distal, Roux-en-Y reconstruction
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
43633 without 51 · national facility
$1,775.93
Partial gastrectomy, distal, Roux-en-Y reconstruction
43633-51 · Second procedure: 50%
$887.97
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%).
43633 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43631Partial gastrectomyDistal, gastroduodenostomy
- Choose 43631 when the distal gastric remnant is connected to the duodenum rather than reconstructed with a Roux-en-Y jejunal limb.
- 43632Partial gastrectomyGastrojejunostomy reconstruction
- Choose 43632 for a distal resection with direct gastrojejunostomy; this code represents Roux-en-Y reconstruction.
- 43620Total gastrectomyEsophagoenterostomy reconstruction
- 43620 represents total stomach removal. This code is for resection of only part of the stomach.
- 43644Gastric bypassRoux-en-Y, laparoscopic
- 43644 describes a laparoscopic Roux-en-Y gastric bypass for a different clinical purpose; it is not the code for distal stomach resection.
43633 billing questions
How does this differ from a direct gastrojejunostomy reconstruction?
Use this code when the distal stomach resection is reconstructed with a Roux-en-Y configuration. A direct gastrojejunostomy reconstruction is represented by 43632.
Does the code include the Roux-en-Y reconstruction?
Yes. The reconstruction is part of the operation described by this code; the operative report should document the gastric resection and Roux-en-Y configuration.
Can modifier 50 be used?
No. The stomach anatomy and procedure do not support bilateral reporting with modifier 50.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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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