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CPT code 43635: Partial gastrectomy, add-on service2026 Medicare rate & RVUs

This add-on reports partial removal of the stomach when performed with a qualifying primary procedure during the same operative service.

CMS RVU26DEffective Oct 1, 2026109 payment localities50 Medicare services in 2024

Medicare pays $100.87 for 43635 nationally in a facility.

Medicare rate · 43635

Partial gastrectomy, add-on service

Office or facility?

Work RVUs
2.01
Total RVUs
3.02
Global days
ZZZ

National rate · 2026

$100.87

Facility setting, before claim adjustments.

See every locality for 43635 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 43635 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43635 covers

CPT 43635 represents partial removal of stomach tissue as an additional operative service accompanying a primary procedure. A surgeon may perform partial stomach resection during an operation when the documented surgical plan requires removal of only part of the stomach. The code identifies the resection service; the primary procedure and the operative details establish the broader surgical context.

Report 43635 only with a primary procedure that permits this add-on, and document the portion of stomach removed and how the work relates to the primary operation. It is not a stand-alone code. CMS treats payment for the add-on as part of the primary procedure’s global period, so the add-on is paid within that period. The primary code should reflect the operation performed; codes 43631–43634 distinguish partial gastrectomy procedures by location and reconstruction.

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 43635 pays more and less

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

109 of 109 payment localities

43635 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$91.18
AlaskaUnavailable$127.53
ArizonaUnavailable$97.82
ArkansasUnavailable$90.02
Atlanta, GAUnavailable$104.89
Austin, TXUnavailable$99.92
Bakersfield, CAUnavailable$96.76
Baltimore area, MDUnavailable$107.31
Beaumont, TXUnavailable$98.17
Brazoria, TXUnavailable$97.37

43635 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
43635 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 43635 rate is calculated

Each of 43635’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 · 43635

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.01

2.01 RVUs× 1.000 GPCI

Practice expense0.48

0.48 RVUs× 1.000 GPCI

Malpractice0.53

0.53 RVUs× 1.000 GPCI

Adjusted RVUs

3.0200

Conversion factor

$33.4009

Medicare rate

$100.87

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 43635

The CMS indicators that decide how 43635 is paid alongside other services.

CMS payment indicators · 43635

Partial gastrectomy, add-on service

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

43635 without 80 · national facility

$100.87

Partial gastrectomy, add-on service

43635-80 · Assistant: 16%

$16.14

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

43635 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 43635

    Partial gastrectomy, add-on service2.01 wRVU

    Not priced

  • 43631

    Partial gastrectomy, distal, gastroduodenostomy23.9 wRVU

    Not priced

  • 43633

    Partial gastrectomy, distal, Roux-en-Y reconstruction32.31 wRVU

    Not priced

  • 43610

    Gastric lesion excision, without partial gastrectomy15.93 wRVU

    Not priced

  • 43620

    Total gastrectomy, esophagoenterostomy reconstruction33.19 wRVU

    Not priced

How to choose

43631Partial gastrectomyDistal, gastroduodenostomy
43631 describes a primary distal partial gastrectomy with gastroduodenostomy. Code 43635 is an add-on and should not replace the primary code.
43633Partial gastrectomyDistal, Roux-en-Y reconstruction
43633 describes a primary distal partial gastrectomy with Roux-en-Y reconstruction. Select the primary code from the documented operation and use 43635 only as an eligible add-on.
43610Gastric lesion excisionWithout partial gastrectomy
43610 describes excision of a stomach lesion. Use the code that matches the documented service; 43635 represents partial stomach removal as an add-on.
43620Total gastrectomyEsophagoenterostomy reconstruction
43620 represents total rather than partial stomach removal. The operative report should establish whether the stomach was removed in part or in its entirety.

Codes related to 43635

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

Codes related to 43635
CodeHow it relatesNational office range
Same family
43631Partial gastrectomy, distal, gastroduodenostomyPrimary distal partial gastrectomy with gastroduodenostomy.No office rate
43632Partial gastrectomy, gastrojejunostomy reconstructionPrimary distal partial gastrectomy with gastrojejunostomy.No office rate
43633Partial gastrectomy, distal, Roux-en-Y reconstructionPrimary distal partial gastrectomy with Roux-en-Y reconstruction.No office rate
43634Partial gastrectomy, distal, Roux-en-Y with vagotomyPrimary proximal partial gastrectomy with esophagogastrostomy.No office rate
Used instead
43610Gastric lesion excision, without partial gastrectomyStomach lesion excision may be reported when the documented service is lesion removal rather than partial gastrectomy.No office rate
43620Total gastrectomy, esophagoenterostomy reconstructionTotal gastrectomy removes the stomach rather than only a portion.No office rate

43635 billing questions

Can 43635 be reported by itself?

No. It is an add-on code and must be reported with a qualifying primary procedure.

How is 43635 different from 43631–43634?

Codes 43631–43634 describe primary partial gastrectomy procedures, with distinctions based on location and reconstruction. Code 43635 is an add-on, not a substitute for those primary procedure codes.

What documentation supports reporting 43635?

The operative report should identify the partial stomach resection performed and explain its relationship to the primary operation.

How does the global period affect payment?

CMS pays 43635 within the global period of the primary procedure. Report it only with that primary procedure.

Should 43635 replace a code for excision of a stomach lesion?

Not based on the short descriptor alone. Distinguish partial stomach resection from lesion excision using the documented extent and nature of the operation.

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
RVUs for 43635PPRRVU2026_Oct_nonQPP.csv, line 5,272 (RVU26D)

Open CMS sourceHow we calculate rates

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