CPT code 43810: Gastroduodenostomy, stomach to duodenum2026 Medicare rate & RVUs in Texas
Reports surgical connection of the stomach to the duodenum, including a Billroth I reconstruction when separately reportable from the associated resection.
CMS doesn’t publish an office rate for 43810 in Texas.
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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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $955.31 |
| Beaumont, TX | Unavailable | $922.17 |
| Brazoria, TX | Unavailable | $925.67 |
| Dallas, TX | Unavailable | $938.98 |
| Fort Worth, TX | Unavailable | $938.29 |
| Galveston, TX | Unavailable | $933.24 |
| Houston, TX | Unavailable | $1,013.78 |
| Rest of Texas | Unavailable | $928.46 |
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
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
| 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 · 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.
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%).
43810 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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