CPT code 43810: Gastroduodenostomy, stomach to duodenum2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $1,048.36 for 43810 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43810 nationwide

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

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.

How Washington, DC area compares for 43810

Across 109 of 109 payment localities, the facility rate for 43810 runs from $843.35 in Wisconsin to $1,191.27 in Miami, FL. Washington, DC area pays $1,048.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43810 rates by state

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

See 43810 in every payment locality

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.

Payment rules and modifiers for 43810

43810 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

Codes related to 43810

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

How 43810 has changed in Washington, DC area

Price 43810 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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