CPT code 43831: Gastrostomy, neonatal, open approach2026 Medicare rate & RVUs in Virginia

In Virginia, Medicare pays $573.04 for 43831 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43831 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 43831 covers

A surgeon creates gastric access through an open abdominal operation in a neonate. The procedure may be chosen when an infant cannot take adequate nutrition by mouth and needs enteral access. Pediatric or general surgeons typically perform it in an operating room, often in an inpatient setting. The operative report should support the neonatal patient population, open approach, and creation of the gastrostomy.

Select this code for the neonatal open procedure rather than an endoscopic or image-guided placement. Document the operative method and any details that distinguish it from other open gastrostomy services. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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, and modifier 50 is inappropriate.

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 Virginia compares for 43831

Across 109 of 109 payment localities, the facility rate for 43831 runs from $528.15 in Arkansas to $726.58 in NYC suburbs and Long Island, NY. Virginia pays $573.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43831 rates by state

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

See 43831 in every payment locality

How the 43831 rate is calculated

Each of 43831’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 43831

43831 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 43831

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

How 43831 has changed in Virginia

Price 43831 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

• Abbs Valley
• Abingdon
• Accomac
• Adwolf
• Afton
• Alberta
• Aldie
• Allison Gap

Browse all communities in Virginia

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