CPT code 43847: Bariatric surgery, small-intestine reconstruction2026 Medicare rate & RVUs in Massachusetts
Reports bariatric gastric bypass that combines a restrictive stomach procedure with small-intestine reconstruction intended to limit nutrient absorption.
CMS doesn’t publish an office rate for 43847 in Massachusetts.
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 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 in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $1,784.50 |
| Rest of Massachusetts | Unavailable | $1,673.52 |
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.
How the rate is built · 43847
RVUs × geographic indexes × conversion factor
Work29.52
29.52 RVUs× 1.000 GPCI
Practice expense13.12
13.12 RVUs× 1.000 GPCI
Malpractice7.90
7.90 RVUs× 1.000 GPCI
Adjusted RVUs
50.5400
Conversion factor
$33.4009
Medicare rate
$1,688.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43847
43847 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43847
Bariatric surgery, small-intestine reconstruction
| 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 · 43847
Bariatric surgery, small-intestine reconstruction
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
43847 without 51 · national facility
$1,688.08
Bariatric surgery, small-intestine reconstruction
43847-51 · Second procedure: 50%
$844.04
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%).
43847 compared with similar codes
Compare codes · National
5 codes, side by side
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.
43847 billing questions
How does this differ from 43846?
Use 43847 when the gastric bypass includes small-intestine reconstruction intended to limit absorption. Code 43846 describes the short-limb Roux-en-Y configuration.
What operative details support reporting 43847?
The operative report should document the restrictive stomach procedure and the intestinal reconstruction, including the altered intestinal route. Those details distinguish this service from a bypass without absorption-limiting reconstruction.
Are related postoperative visits included?
Yes. The 90-day major-surgery global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other procedures performed in the same session handled?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction. The operative record should support each separately reported procedure.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
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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