CPT code 43635: Partial gastrectomy, add-on service2026 Medicare rate & RVUs in New Mexico
This add-on reports partial removal of the stomach when performed with a qualifying primary procedure during the same operative service.
In New Mexico, Medicare pays $103.10 for 43635 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43635 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How New Mexico compares for 43635
Across 109 of 109 payment localities, the facility rate for 43635 runs from $87.95 in Wisconsin to $128.60 in Miami, FL. New Mexico pays $103.10. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$103.10
- Los Angeles, CA · California$100.61−$2.49
- Washington, DC area · District of Columbia$109.35+$6.25
- Miami, FL · Florida$128.60+$25.50
- Chicago, IL · Illinois$124.35+$21.25
- Manhattan, NY · New York$118.14+$15.04
- Alaska · Alaska$127.53+$24.43
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $91.18 |
| ArkansasArkansas | — | $90.02 |
| ArizonaArizona | — | $97.82 |
| Bakersfield, CACalifornia | — | $96.76 |
| Chico, CACalifornia | — | $95.34 |
| El Centro, CACalifornia | — | $95.43 |
| Fresno, CACalifornia | — | $95.34 |
| Hanford, CACalifornia | — | $95.34 |
| Madera, CACalifornia | — | $95.34 |
| Merced, CACalifornia | — | $95.34 |
| Modesto, CACalifornia | — | $95.34 |
| Napa, CACalifornia | — | $101.49 |
| Oxnard, CACalifornia | — | $98.99 |
| Redding, CACalifornia | — | $95.34 |
| Rest of CaliforniaCalifornia | — | $95.34 |
| Riverside, CACalifornia | — | $101.02 |
| Sacramento, CACalifornia | — | $97.69 |
| Salinas, CACalifornia | — | $97.29 |
| San Diego, CACalifornia | — | $97.92 |
| Marin County, CACalifornia | — | $104.24 |
| San Francisco, CACalifornia | — | $103.64 |
| San Benito County, CACalifornia | — | $107.13 |
| Santa Clara County, CACalifornia | — | $104.67 |
| San Luis Obispo, CACalifornia | — | $96.03 |
| Santa Cruz, CACalifornia | — | $97.51 |
| Santa Maria, CACalifornia | — | $97.20 |
| Santa Rosa, CACalifornia | — | $98.33 |
| Stockton, CACalifornia | — | $95.34 |
| Vallejo, CACalifornia | — | $100.62 |
| Visalia, CACalifornia | — | $95.34 |
| Yuba City, CACalifornia | — | $95.34 |
| ColoradoColorado | — | $98.83 |
| ConnecticutConnecticut | — | $107.17 |
| DelawareDelaware | — | $99.23 |
| Fort Lauderdale, FLFlorida | — | $115.38 |
| Rest of FloridaFlorida | — | $109.07 |
| Atlanta, GAGeorgia | — | $104.89 |
| Rest of GeorgiaGeorgia | — | $102.54 |
| Hawaii, Guam, HIHawaii | — | $95.61 |
| IowaIowa | — | $88.83 |
| IdahoIdaho | — | $90.26 |
| East St. Louis, ILIllinois | — | $117.54 |
| Rest of IllinoisIllinois | — | $109.44 |
| Suburban Chicago, ILIllinois | — | $115.44 |
| IndianaIndiana | — | $90.60 |
| KansasKansas | — | $90.55 |
| KentuckyKentucky | — | $97.59 |
| New Orleans, LALouisiana | — | $102.33 |
| Rest of LouisianaLouisiana | — | $98.28 |
| Metropolitan Boston, MAMassachusetts | — | $104.79 |
| Rest of MassachusettsMassachusetts | — | $99.20 |
| Baltimore area, MDMaryland | — | $107.31 |
| Rest of MarylandMaryland | — | $100.28 |
| Rest of MaineMaine | — | $92.90 |
| Southern Maine, MEMaine | — | $94.19 |
| Detroit, MIMichigan | — | $112.45 |
| Rest of MichiganMichigan | — | $101.76 |
| MinnesotaMinnesota | — | $88.87 |
| Metropolitan Kansas City, MOMissouri | — | $99.49 |
| Metropolitan St. Louis, MOMissouri | — | $100.14 |
| Rest of MissouriMissouri | — | $98.20 |
| MississippiMississippi | — | $94.02 |
| MontanaMontana | — | $100.84 |
| North CarolinaNorth Carolina | — | $93.41 |
| North DakotaNorth Dakota | — | $90.36 |
| NebraskaNebraska | — | $88.63 |
| New HampshireNew Hampshire | — | $99.32 |
| Northern New JerseyNew Jersey | — | $108.87 |
| Rest of New JerseyNew Jersey | — | $106.75 |
| NevadaNevada | — | $97.93 |
| NYC suburbs and Long Island, NYNew York | — | $123.37 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $109.13 |
| Queens, NYNew York | — | $115.91 |
| Rest of New YorkNew York | — | $94.81 |
| OhioOhio | — | $99.62 |
| OklahomaOklahoma | — | $95.21 |
| Portland, OROregon | — | $99.19 |
| Rest of OregonOregon | — | $95.55 |
| Metropolitan Philadelphia, PAPennsylvania | — | $106.15 |
| Rest of PennsylvaniaPennsylvania | — | $98.58 |
| Puerto RicoPuerto Rico | — | $100.78 |
| Rhode IslandRhode Island | — | $100.76 |
| South CarolinaSouth Carolina | — | $97.00 |
| South DakotaSouth Dakota | — | $89.12 |
| TennesseeTennessee | — | $91.22 |
| Austin, TXTexas | — | $99.92 |
| Beaumont, TXTexas | — | $98.17 |
| Brazoria, TXTexas | — | $97.37 |
| Dallas, TXTexas | — | $98.90 |
| Fort Worth, TXTexas | — | $98.97 |
| Galveston, TXTexas | — | $98.25 |
| Houston, TXTexas | — | $107.95 |
| Rest of TexasTexas | — | $98.34 |
| UtahUtah | — | $98.10 |
| VirginiaVirginia | — | $95.39 |
| Virgin Islands, VIUnited States Virgin Islands | — | $100.78 |
| VermontVermont | — | $91.97 |
| Rest of WashingtonWashington | — | $98.36 |
| King County, WAWashington | — | $104.63 |
| WisconsinWisconsin | — | $87.95 |
| West VirginiaWest Virginia | — | $106.40 |
| WyomingWyoming | — | $96.27 |
43635 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,272
- Code
- 43635
- Physician work
- 2.01
- Practice expense
- 0.48
- Malpractice
- 0.53
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.01 | × 1.000 | 2.0100 |
| Practice expense | 0.48 | × 0.917 | 0.4402 |
| Malpractice | 0.53 | × 1.201 | 0.6365 |
| Total RVUs | 3.0867 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$103.10
Facility: (2.01 × 1 + 0.48 × 0.917 + 0.53 × 1.201) × $33.4009 = $103.10
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
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.
How 43635 has changed in New Mexico
43635 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $103.10 | RVU26D |
| 2026-07-01 | Not available in this setting | $103.10 | RVU26C |
| 2026-04-01 | Not available in this setting | $103.10 | RVU26B |
| 2026-01-01 | Not available in this setting | $103.10 | RVU26A |
| 2025-10-01 | Not available in this setting | $109.26 | RVU25D |
| 2025-07-01 | Not available in this setting | $109.26 | RVU25C |
| 2025-04-01 | Not available in this setting | $109.26 | RVU25B |
| 2025-01-01 | Not available in this setting | $109.26 | RVU25A |
| 2024-10-01 | Not available in this setting | $111.83 | RVU24D |
| 2024-07-01 | Not available in this setting | $111.83 | RVU24C |
| 2024-04-01 | Not available in this setting | $111.83 | RVU24B |
| 2024-03-09 | Not available in this setting | $111.83 | RVU24AR |
| 2024-01-01 | Not available in this setting | $110.00 | RVU24A |
| 2023-10-01 | Not available in this setting | $113.55 | RVU23D |
| 2023-07-01 | Not available in this setting | $113.55 | RVU23C |
| 2023-04-01 | Not available in this setting | $113.55 | RVU23B |
| 2023-01-01 | Not available in this setting | $113.55 | RVU23A |
| 2022-10-01 | Not available in this setting | $115.34 | RVU22D |
| 2022-07-01 | Not available in this setting | $115.34 | RVU22C |
| 2022-04-01 | Not available in this setting | $115.34 | RVU22B |
| 2022-01-01 | Not available in this setting | $115.34 | RVU22A |
| 2021-10-01 | Not available in this setting | $115.17 | RVU21D |
| 2021-07-01 | Not available in this setting | $115.17 | RVU21C |
| 2021-04-01 | Not available in this setting | $115.17 | RVU21B |
| 2021-01-01 | Not available in this setting | $115.17 | RVU21A |
| 2020-10-01 | Not available in this setting | $119.94 | RVU20D |
| 2020-07-01 | Not available in this setting | $119.94 | RVU20C |
| 2020-04-01 | Not available in this setting | $119.94 | RVU20B |
| 2020-01-01 | Not available in this setting | $119.94 | RVU20A |
| 2019-10-01 | Not available in this setting | $119.71 | RVU19D |
| 2019-07-01 | Not available in this setting | $119.71 | RVU19C |
| 2019-04-01 | Not available in this setting | $119.71 | RVU19B |
| 2019-01-01 | Not available in this setting | $119.71 | RVU19A |
| 2018-10-01 | Not available in this setting | $120.48 | RVU18D |
| 2018-07-01 | Not available in this setting | $120.48 | RVU18C |
| 2018-04-01 | Not available in this setting | $120.48 | RVU18B |
| 2018-01-01 | Not available in this setting | $120.48 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $119.21 | RVU17D |
| 2017-07-01 | Not available in this setting | $119.21 | RVU17C |
| 2017-04-01 | Not available in this setting | $119.21 | RVU17B |
| 2017-01-01 | Not available in this setting | $119.21 | RVU17A |
| 2016-10-01 | Not available in this setting | $117.82 | RVU16D |
| 2016-07-01 | Not available in this setting | $117.82 | RVU16C |
| 2016-04-01 | Not available in this setting | $117.82 | RVU16B |
| 2016-01-01 | Not available in this setting | $117.82 | RVU16A |
| 2015-10-01 | Not available in this setting | $118.15 | RVU15D |
| 2015-07-01 | Not available in this setting | $118.15 | RVU15C |
| 2015-04-01 | Not available in this setting | $117.57 | RVU15B |
| 2015-01-01 | Not available in this setting | $117.57 | RVU15A |
| 2014-10-01 | Not available in this setting | $113.26 | RVU14D |
| 2014-07-01 | Not available in this setting | $113.26 | RVU14C |
| 2014-04-01 | Not available in this setting | $113.26 | RVU14B |
| 2014-01-01 | Not available in this setting | $113.26 | RVU14A |
| 2013-10-01 | Not available in this setting | $109.58 | RVU13D |
| 2013-07-01 | Not available in this setting | $109.58 | RVU13C |
| 2013-04-01 | Not available in this setting | $109.58 | RVU13B |
| 2013-01-01 | Not available in this setting | $109.58 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
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
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