CPT code 43847: Bariatric surgery, small-intestine reconstruction2026 Medicare rate & RVUs

Medicare pays $1,688.08 for 43847 nationally in a facility.

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

What 43847 covers

This code describes a bariatric operation that creates a smaller stomach pouch and reroutes the small intestine so the altered path limits absorption as well as food intake. A bariatric surgeon typically performs it in a hospital operating room for a patient undergoing surgical treatment of obesity. The operative report should show both the gastric restrictive work and the intestinal reconstruction; a gastric bypass without that absorption-limiting reconstruction is a different service.

Report the code for the operation actually performed, using the operative details to distinguish it from other gastric bypass configurations and from procedures that do not include bypass. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure 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 43847 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

43847 rates by state

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

How the 43847 rate is calculated

Each of 43847’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 43847

43847 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

43847 compared with similar codes

How to choose

43846Gastric bypassShort-limb Roux-en-Y

43846 identifies a short-limb Roux-en-Y configuration. Choose 43847 when the documented gastric bypass includes small-intestine reconstruction intended to limit absorption.

43845Duodenal switchPylorus-preserving reconstruction

43845 describes a duodenal-switch approach with its own gastric and intestinal reconstruction. It is not interchangeable with the bypass configuration reported by 43847.

43842Gastric restrictionVertical banded

43842 is for vertical-banded gastroplasty, a restrictive operation without the gastric bypass and intestinal reconstruction of 43847.

43843Gastric restrictionOther than vertical-banded gastroplasty

43843 covers another restrictive gastric procedure without gastric bypass. Report 43847 when the operative report supports the bypass and absorption-limiting intestinal reconstruction.

Codes related to 43847

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

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