CPT code 43832: Open gastrostomy, with gastric tube construction2026 Medicare rate & RVUs in California
Reports open abdominal gastrostomy in which the surgeon constructs a gastric tube, commonly to establish durable access for feeding or drainage.
CMS doesn’t publish an office rate for 43832 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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What 43832 covers
A surgeon performs this operation through an abdominal incision, bringing part of the stomach to the abdominal wall and constructing a tube-like channel from gastric tissue. It may be chosen when a patient needs durable access for enteral feeding or gastric drainage and an open approach is performed. General surgeons and pediatric surgeons typically perform the procedure in an operating room; the neonatal service has a separate code.
Report this code when the operative note supports both an open approach and construction of the gastric tube. The construction is part of the reported operation, not a separate service. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 43832 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 | $965.91 |
| Chico, CA | Unavailable | $954.10 |
| El Centro, CA | Unavailable | $954.84 |
| Fresno, CA | Unavailable | $954.10 |
| Hanford, CA | Unavailable | $954.10 |
| Los Angeles, CA | Unavailable | $1,010.30 |
| Madera, CA | Unavailable | $954.10 |
| Marin County, CA | Unavailable | $1,073.21 |
| Merced, CA | Unavailable | $954.10 |
| Modesto, CA | Unavailable | $954.10 |
| Napa, CA | Unavailable | $1,037.01 |
| Oxnard, CA | Unavailable | $996.69 |
| Redding, CA | Unavailable | $954.10 |
| Rest of California | Unavailable | $954.10 |
| Riverside, CA | Unavailable | $1,001.05 |
| Sacramento, CA | Unavailable | $983.25 |
| Salinas, CA | Unavailable | $979.33 |
| San Benito County, CA | Unavailable | $1,101.74 |
| San Diego, CA | Unavailable | $989.81 |
| San Francisco, CA | Unavailable | $1,068.24 |
| San Luis Obispo, CA | Unavailable | $965.92 |
| Santa Clara County, CA | Unavailable | $1,081.41 |
| Santa Cruz, CA | Unavailable | $989.08 |
| Santa Maria, CA | Unavailable | $979.56 |
| Santa Rosa, CA | Unavailable | $997.73 |
| Stockton, CA | Unavailable | $954.10 |
| Vallejo, CA | Unavailable | $1,029.85 |
| Visalia, CA | Unavailable | $954.10 |
| Yuba City, CA | Unavailable | $954.10 |
How the 43832 rate is calculated
Each of 43832’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 · 43832
RVUs × geographic indexes × conversion factor
Work16.91
16.91 RVUs× 1.000 GPCI
Practice expense8.23
8.23 RVUs× 1.000 GPCI
Malpractice4.38
4.38 RVUs× 1.000 GPCI
Adjusted RVUs
29.5200
Conversion factor
$33.4009
Medicare rate
$985.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43832
43832 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43832
Open gastrostomy, with gastric tube construction
| 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 · 43832
Open gastrostomy, with gastric tube construction
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
43832 without 51 · national facility
$985.99
Open gastrostomy, with gastric tube construction
43832-51 · Second procedure: 50%
$493.00
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%).
43832 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43830GastrostomyOpen, no gastric tube construction
- Choose 43832 when the open operation includes construction of a gastric tube. Choose 43830 when that construction is not performed.
- 43831GastrostomyNeonatal, open approach
- 43831 is the neonatal open gastrostomy code. This code is for the non-neonatal service when a gastric tube is constructed.
- 43653GastrostomyLaparoscopic approach
- 43653 describes laparoscopic gastrostomy. This code describes an open operation with gastric tube construction.
- 49440Gastrostomy placementPercutaneous, image-guided
- 49440 describes percutaneous, image-guided gastrostomy tube placement; this code represents an open surgical approach with gastric tube construction.
43832 billing questions
How does this differ from 43830?
Both describe open gastrostomy, but 43832 requires construction of a gastric tube. Use 43830 when the open procedure is performed without that construction.
What operative documentation supports 43832?
The operative report should establish the open approach and describe construction of the gastric tube, along with the clinical purpose, such as feeding access or drainage.
Can the gastric tube construction be billed separately?
No. The construction is included in this gastrostomy service; it is not a separately reported component.
Does modifier 50 apply to this code?
No. CMS identifies bilateral adjustment as inappropriate for this procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is provided.
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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