CPT code 43820: Gastrojejunostomy, without vagotomy2026 Medicare rate & RVUs in California
Reports surgical creation of a stomach-to-jejunum connection without vagotomy, typically to bypass impaired gastric outflow or reconstruct gastrointestinal continuity.
CMS doesn’t publish an office rate for 43820 in California.
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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On this page 9 sections
What 43820 covers
A surgeon creates an anastomosis between the stomach and jejunum, routing gastric contents past the usual outlet and intervening duodenum. General or gastrointestinal surgeons perform this operation in the operating room, commonly for gastric outlet obstruction or when reconstruction requires a stomach-to-small-bowel connection. The operative record should identify the anastomosis and whether vagotomy was performed; the presence of vagotomy distinguishes this service from its paired code.
Report 43820 for the gastrojejunostomy when no vagotomy is performed. Documentation should establish the surgical indication, the stomach-to-jejunum connection, and whether the procedure is an initial construction rather than revision of an existing anastomosis. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and 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 43820 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,230.55 |
| Chico, CA | Unavailable | $1,215.58 |
| El Centro, CA | Unavailable | $1,216.50 |
| Fresno, CA | Unavailable | $1,215.58 |
| Hanford, CA | Unavailable | $1,215.58 |
| Los Angeles, CA | Unavailable | $1,286.25 |
| Madera, CA | Unavailable | $1,215.58 |
| Marin County, CA | Unavailable | $1,364.60 |
| Merced, CA | Unavailable | $1,215.58 |
| Modesto, CA | Unavailable | $1,215.58 |
| Napa, CA | Unavailable | $1,319.12 |
| Oxnard, CA | Unavailable | $1,268.79 |
| Redding, CA | Unavailable | $1,215.58 |
| Rest of California | Unavailable | $1,215.58 |
| Riverside, CA | Unavailable | $1,274.97 |
| Sacramento, CA | Unavailable | $1,252.14 |
| Salinas, CA | Unavailable | $1,247.12 |
| San Benito County, CA | Unavailable | $1,400.66 |
| San Diego, CA | Unavailable | $1,259.99 |
| San Francisco, CA | Unavailable | $1,358.31 |
| San Luis Obispo, CA | Unavailable | $1,230.10 |
| Santa Clara County, CA | Unavailable | $1,374.94 |
| Santa Cruz, CA | Unavailable | $1,258.69 |
| Santa Maria, CA | Unavailable | $1,247.29 |
| Santa Rosa, CA | Unavailable | $1,269.69 |
| Stockton, CA | Unavailable | $1,215.58 |
| Vallejo, CA | Unavailable | $1,310.05 |
| Visalia, CA | Unavailable | $1,215.58 |
| Yuba City, CA | Unavailable | $1,215.58 |
How the 43820 rate is calculated
Each of 43820’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 · 43820
RVUs × geographic indexes × conversion factor
Work21.97
21.97 RVUs× 1.000 GPCI
Practice expense10.11
10.11 RVUs× 1.000 GPCI
Malpractice5.54
5.54 RVUs× 1.000 GPCI
Adjusted RVUs
37.6200
Conversion factor
$33.4009
Medicare rate
$1,256.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43820
43820 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43820
Gastrojejunostomy, without vagotomy
| 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 · 43820
Gastrojejunostomy, without vagotomy
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
43820 without 51 · national facility
$1,256.54
Gastrojejunostomy, without vagotomy
43820-51 · Second procedure: 50%
$628.27
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%).
43820 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43825GastrojejunostomyWith vagotomy
- Both codes describe gastrojejunostomy; choose 43825 when vagotomy is performed and 43820 when it is not.
- 43810GastroduodenostomyStomach to duodenum
- The destination bowel segment differs: 43810 connects the stomach to the duodenum, while 43820 connects it to the jejunum.
- 43860Anastomosis revisionWithout vagotomy
- Code 43860 is for revision of an existing gastrojejunostomy without vagotomy, rather than creation of the connection.
- 43800Pyloroplasty
- Code 43800 describes pyloroplasty, which treats the outlet by altering the pylorus; 43820 creates a stomach-to-jejunum bypass.
43820 billing questions
When should 43820 be selected instead of 43825?
Use 43820 when the gastrojejunostomy is performed without vagotomy. When vagotomy is performed with the gastrojejunostomy, 43825 is the corresponding code.
How does this differ from gastroduodenostomy?
Code 43820 describes a connection from the stomach to the jejunum. Code 43810 describes a connection from the stomach to the duodenum.
Does 43820 cover postoperative visits?
Medicare assigns a 90-day global period. It includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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 when performed in the same session.
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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