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

Reports bariatric gastric bypass that combines a restrictive stomach procedure with small-intestine reconstruction intended to limit nutrient absorption.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Vermont, Medicare pays $1,553.35 for 43847 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,553.35Hospital or facility

Check a contract rate as a % of Medicare · 43847 nationwide

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

We’ll open 43847 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 43847 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Vermont compares for 43847

Across 109 of 109 payment localities, the facility rate for 43847 runs from $1,487.08 in Wisconsin to $2,109.50 in Miami, FL. Vermont pays $1,553.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

43847 in Vermont vs other payment areas
  1. Vermont · this page$1,553.35
  2. Los Angeles, CA · California$1,720.04+$166.69
  3. Washington, DC area · District of Columbia$1,849.15+$295.80
  4. Miami, FL · Florida$2,109.50+$556.15
  5. Chicago, IL · Illinois$2,038.88+$485.53
  6. Manhattan, NY · New York$1,976.80+$423.45
  7. Alaska · Alaska$2,091.09+$537.74

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

43847 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,518.79
ArkansasArkansas—$1,498.32
ArizonaArizona—$1,636.50
Bakersfield, CACalifornia—$1,645.71
Chico, CACalifornia—$1,624.48
El Centro, CACalifornia—$1,625.80
Fresno, CACalifornia—$1,624.48
Hanford, CACalifornia—$1,624.48

43847 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
43847 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 43847 in every payment locality

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

Office or facility?

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.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,310

Code
43847
Physician work
29.52
Practice expense
13.12
Malpractice
7.90

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Facility calculation for 43847 in Vermont
ComponentRVULocality factorAdjusted
Physician work29.52× 1.00029.5200
Practice expense13.12× 0.99012.9888
Malpractice7.90× 0.5063.9974
Total RVUs46.5062
Conversion factor× 33.4009

Facility rate, Vermont$1553.35

Facility: (29.52 × 1 + 13.12 × 0.99 + 7.9 × 0.506) × $33.4009 = $1553.35

Open 43847 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

How 43847 has changed in Vermont

43847 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,553.35RVU26D
2026-07-01Not available in this setting$1,553.35RVU26C
2026-04-01Not available in this setting$1,553.35RVU26B
2026-01-01Not available in this setting$1,553.35RVU26A
2025-10-01Not available in this setting$1,639.58RVU25D
2025-07-01Not available in this setting$1,639.58RVU25C
2025-04-01Not available in this setting$1,639.58RVU25B
2025-01-01Not available in this setting$1,639.58RVU25A
2024-10-01Not available in this setting$1,676.60RVU24D
2024-07-01Not available in this setting$1,676.60RVU24C
2024-04-01Not available in this setting$1,676.60RVU24B
2024-03-09Not available in this setting$1,676.60RVU24AR
2024-01-01Not available in this setting$1,649.24RVU24A
2023-10-01Not available in this setting$1,710.39RVU23D
2023-07-01Not available in this setting$1,710.39RVU23C
2023-04-01Not available in this setting$1,710.39RVU23B
2023-01-01Not available in this setting$1,710.39RVU23A
2022-10-01Not available in this setting$1,755.88RVU22D
2022-07-01Not available in this setting$1,755.88RVU22C
2022-04-01Not available in this setting$1,755.88RVU22B
2022-01-01Not available in this setting$1,755.88RVU22A
2021-10-01Not available in this setting$1,756.24RVU21D
2021-07-01Not available in this setting$1,756.24RVU21C
2021-04-01Not available in this setting$1,756.24RVU21B
2021-01-01Not available in this setting$1,756.24RVU21A
2020-10-01Not available in this setting$1,795.39RVU20D
2020-07-01Not available in this setting$1,795.39RVU20C
2020-04-01Not available in this setting$1,795.39RVU20B
2020-01-01Not available in this setting$1,795.39RVU20A
2019-10-01Not available in this setting$1,789.89RVU19D
2019-07-01Not available in this setting$1,789.89RVU19C
2019-04-01Not available in this setting$1,783.02RVU19B
2019-01-01Not available in this setting$1,783.02RVU19A
2018-10-01Not available in this setting$1,783.65RVU18D
2018-07-01Not available in this setting$1,783.65RVU18C
2018-04-01Not available in this setting$1,783.65RVU18B
2018-01-01Not available in this setting$1,783.65RVU18AR1
2017-10-01Not available in this setting$1,764.50RVU17D
2017-07-01Not available in this setting$1,764.50RVU17C
2017-04-01Not available in this setting$1,764.50RVU17B
2017-01-01Not available in this setting$1,764.50RVU17A
2016-10-01Not available in this setting$1,770.06RVU16D
2016-07-01Not available in this setting$1,770.06RVU16C
2016-04-01Not available in this setting$1,770.06RVU16B
2016-01-01Not available in this setting$1,770.06RVU16A
2015-10-01Not available in this setting$1,796.32RVU15D
2015-07-01Not available in this setting$1,796.32RVU15C
2015-04-01Not available in this setting$1,787.38RVU15B
2015-01-01Not available in this setting$1,787.38RVU15A
2014-10-01Not available in this setting$1,755.03RVU14D
2014-07-01Not available in this setting$1,755.03RVU14C
2014-04-01Not available in this setting$1,755.03RVU14B
2014-01-01Not available in this setting$1,755.03RVU14A
2013-10-01Not available in this settingRate data unavailableRVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 43847 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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
RVUs for 43847PPRRVU2026_Oct_nonQPP.csv, line 5,310 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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