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CPT code 43810: Gastroduodenostomy, stomach to duodenum2026 Medicare rate & RVUs

Reports surgical connection of the stomach to the duodenum, including a Billroth I reconstruction when separately reportable from the associated resection.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $955.93 for 43810 nationally in a facility.

Medicare rate · 43810

Gastroduodenostomy, stomach to duodenum

Office or facility?

Work RVUs
16.46
Total RVUs
28.62
Global days
090

National rate · 2026

$955.93

Facility setting, before claim adjustments.

See every locality for 43810 →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 43810 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 43810 covers

The surgeon joins the stomach or gastric remnant directly to the duodenum to restore gastrointestinal continuity. This connection is commonly part of a Billroth I reconstruction after distal stomach resection and is performed in an operating room, usually by a general or gastrointestinal surgeon. When a distal partial gastrectomy code already describes the resection with gastroduodenostomy, the anastomosis is included rather than separately reported with this code.

Report this code when the operative record supports a distinct stomach-to-duodenum anastomosis and the complete operation is not better represented by a combined gastrectomy code. Documentation should identify the structures joined, the reconstruction performed, and any associated resection. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. 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 43810 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

43810 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$859.75
AlaskaUnavailable$1,181.68
ArizonaUnavailable$926.74
ArkansasUnavailable$848.11
Atlanta, GAUnavailable$991.27
Austin, TXUnavailable$955.31
Bakersfield, CAUnavailable$933.80
Baltimore area, MDUnavailable$1,018.48
Beaumont, TXUnavailable$922.17
Brazoria, TXUnavailable$925.67

43810 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
43810 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 43810 rate is calculated

Each of 43810’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 · 43810

RVUs × geographic indexes × conversion factor

Office or facility?

Work16.46

16.46 RVUs× 1.000 GPCI

Practice expense7.76

7.76 RVUs× 1.000 GPCI

Malpractice4.40

4.40 RVUs× 1.000 GPCI

Adjusted RVUs

28.6200

Conversion factor

$33.4009

Medicare rate

$955.93

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

Payment rules and modifiers for 43810

43810 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43810

Gastroduodenostomy, stomach to duodenum

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 43810

Gastroduodenostomy, stomach to duodenum

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43810 without 51 · national facility

$955.93

Gastroduodenostomy, stomach to duodenum

43810-51 · Second procedure: 50%

$477.97

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%).

When to use modifier 51

43810 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 43810

    Gastroduodenostomy, stomach to duodenum16.46 wRVU

    Not priced

  • 43820

    Gastrojejunostomy, without vagotomy21.97 wRVU

    Not priced

  • 43825

    Gastrojejunostomy, with vagotomy21.22 wRVU

    Not priced

  • 43800

    Pyloroplasty15.04 wRVU

    Not priced

  • 43631

    Partial gastrectomy, distal, gastroduodenostomy23.9 wRVU

    Not priced

How to choose

43820GastrojejunostomyWithout vagotomy
Use 43820 when the anastomosis joins the stomach to the jejunum and no vagotomy is performed; 43810 joins the stomach to the duodenum.
43825GastrojejunostomyWith vagotomy
Use 43825 for a stomach-to-jejunum anastomosis performed with vagotomy. The destination in 43810 is the duodenum.
43800Pyloroplasty
43800 is a pyloroplasty that enlarges the gastric outlet; it does not create a stomach-to-duodenum anastomosis.
43631Partial gastrectomyDistal, gastroduodenostomy
When distal partial gastrectomy with gastroduodenostomy is performed, 43631 describes the combined operation rather than separately reporting the anastomosis.

Codes related to 43810

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

Codes related to 43810
CodeHow it relatesNational office range
Used instead
43820Gastrojejunostomy, without vagotomyConnects the stomach to the jejunum rather than the duodenum, without vagotomy.No office rate
43825Gastrojejunostomy, with vagotomyConnects the stomach to the jejunum rather than the duodenum, with vagotomy.No office rate
Component of
43631Partial gastrectomy, distal, gastroduodenostomyA distal partial gastrectomy code includes gastroduodenostomy when that reconstruction is performed.No office rate

43810 billing questions

When is this code appropriate instead of a gastrectomy code?

Use it for a distinct stomach-to-duodenum anastomosis when the operation is not already described by a combined gastrectomy code. A distal partial gastrectomy code that includes gastroduodenostomy represents the combined operation.

How does this differ from a gastrojejunostomy?

This procedure connects the stomach to the duodenum. A gastrojejunostomy connects the stomach to the jejunum instead.

What documentation supports reporting it?

The operative report should identify the stomach and duodenum as the structures joined and describe the reconstruction. It should also clarify whether a gastrectomy code already captures the anastomosis.

How is the 90-day global period applied?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 43810PPRRVU2026_Oct_nonQPP.csv, line 5,299 (RVU26D)

Open CMS sourceHow we calculate rates

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