CPT code 43889: Sleeve gastroplasty, transoral endoscopic2026 Medicare rate & RVUs in California
Reports endoscopic stomach plication performed through the mouth to reduce gastric capacity as a restrictive treatment for obesity.
CMS doesn’t publish an office rate for 43889 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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On this page 9 sections
What 43889 covers
The endoscopist passes a flexible endoscope through the mouth and places sutures to fold and narrow the stomach, reducing its capacity without abdominal incisions or removal of stomach tissue. A gastroenterologist or bariatric surgeon may perform the procedure in a hospital or ambulatory surgical setting. The operative report should identify the transoral approach and describe the endoscopic suturing and gastric plication performed.
Report this code for the endoscopic sleeve gastroplasty itself, not for a surgical sleeve resection or a revision of prior bariatric surgery. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When related endoscopies are performed together, endoscopy-family pricing applies. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are 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 43889 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 | $724.22 |
| Chico, CA | Unavailable | $718.53 |
| El Centro, CA | Unavailable | $718.86 |
| Fresno, CA | Unavailable | $718.53 |
| Hanford, CA | Unavailable | $718.53 |
| Los Angeles, CA | Unavailable | $757.44 |
| Madera, CA | Unavailable | $718.53 |
| Marin County, CA | Unavailable | $819.54 |
| Merced, CA | Unavailable | $718.53 |
| Modesto, CA | Unavailable | $718.53 |
| Napa, CA | Unavailable | $787.87 |
| Oxnard, CA | Unavailable | $749.03 |
| Redding, CA | Unavailable | $718.53 |
| Rest of California | Unavailable | $718.53 |
| Riverside, CA | Unavailable | $740.02 |
| Sacramento, CA | Unavailable | $742.16 |
| Salinas, CA | Unavailable | $739.13 |
| San Benito County, CA | Unavailable | $838.44 |
| San Diego, CA | Unavailable | $747.76 |
| San Francisco, CA | Unavailable | $817.28 |
| San Luis Obispo, CA | Unavailable | $728.58 |
| Santa Clara County, CA | Unavailable | $829.20 |
| Santa Cruz, CA | Unavailable | $748.03 |
| Santa Maria, CA | Unavailable | $739.51 |
| Santa Rosa, CA | Unavailable | $754.84 |
| Stockton, CA | Unavailable | $718.53 |
| Vallejo, CA | Unavailable | $784.61 |
| Visalia, CA | Unavailable | $718.53 |
| Yuba City, CA | Unavailable | $718.53 |
How the 43889 rate is calculated
Each of 43889’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 · 43889
RVUs × geographic indexes × conversion factor
Work12.56
12.56 RVUs× 1.000 GPCI
Practice expense7.00
7.00 RVUs× 1.000 GPCI
Malpractice1.99
1.99 RVUs× 1.000 GPCI
Adjusted RVUs
21.5500
Conversion factor
$33.4009
Medicare rate
$719.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43889
43889 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43889
Sleeve gastroplasty, transoral endoscopic
| 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 | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43889
Sleeve gastroplasty, transoral endoscopic
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
43889 without 51 · national facility
$719.79
Sleeve gastroplasty, transoral endoscopic
43889-51 · Second procedure: 50%
$359.90
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%).
43889 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43842Gastric restrictionVertical banded
- Use 43889 for transoral endoscopic stomach plication. Code 43842 represents a surgical restrictive procedure using a different operative approach.
- 43843Gastric restrictionOther than vertical-banded gastroplasty
- Code 43843 describes a surgical restrictive procedure other than the operation represented by 43842; it is not the transoral endoscopic plication reported with 43889.
- 43846Gastric bypassShort-limb Roux-en-Y
- Code 43846 involves open restrictive surgery with gastric bypass. Code 43889 is an endoscopic restrictive procedure without that bypass operation.
- 43848Bariatric revisionOpen approach
- Code 43848 is for revision of an open gastric restrictive procedure. Use 43889 for a transoral endoscopic sleeve gastroplasty, not a revision operation.
43889 billing questions
How does this differ from surgical gastric restriction codes?
This code is for stomach plication performed transorally with an endoscope. Codes such as 43842 and 43843 describe surgical restrictive procedures, not endoscopic sleeve gastroplasty.
Can a related endoscopy be reported separately on the same date?
CMS applies endoscopy-family pricing when related endoscopies are performed together. Review the operative services and applicable endoscopy-family pricing rather than assuming each endoscopy is priced independently.
What documentation supports reporting this code?
The operative report should establish the transoral endoscopic approach and describe the suturing and stomach plication performed. Documentation of a different surgical bariatric procedure does not support this code.
Can an assistant surgeon be billed?
Assistant-at-surgery payment is available only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
What postoperative services are included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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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