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Billing code 43332: Hiatal hernia repairMedicare rate & RVUs

Reports open abdominal repair of a paraesophageal hiatal hernia when the operation does not include fundoplasty or mesh implantation.

CMS RVU26DEffective Oct 1, 2026109 payment localities539 Medicare services in 2024

Medicare pays $1,077.85 for 43332 nationally in a facility.

Medicare rate · 43332

Hiatal hernia repair

Swap in your local Medicare rate.

Work RVUs
19.13
Total RVUs
32.27
Global days
090

National rate · 2026

$1,077.85

Facility setting, before claim adjustments.

See every locality for 43332 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 43332 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43332 covers

This code describes an open abdominal operation to repair a paraesophageal hiatal hernia. The surgeon brings herniated stomach or other displaced contents back into the abdomen and repairs the enlarged opening in the diaphragm. General and foregut surgeons commonly perform the procedure in a hospital operating room. The code distinguishes a repair performed without fundoplasty and without mesh from related approaches and repairs that include those features.

Report the code when the operative report supports the transabdominal approach and confirms that neither fundoplasty nor mesh implantation was performed. Documentation should describe the hernia repair and the operative approach; use a related code when the operation includes a different approach, fundoplasty, or mesh. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure setting, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this repair.

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 43332 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

43332 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$972.62
Alaska*Unavailable$1,342.07
ArizonaUnavailable$1,045.82
ArkansasUnavailable$959.89
AtlantaUnavailable$1,116.94
AustinUnavailable$1,076.55
BakersfieldUnavailable$1,052.74
Baltimore/Surr. CntysUnavailable$1,146.84
BeaumontUnavailable$1,041.44
BrazoriaUnavailable$1,044.62

43332 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
43332 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

How the 43332 rate is calculated

Each of 43332’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 · 43332

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.13Practice expense 8.26Malpractice 4.88

32.2700 adjusted RVUs×$33.4009 conversion factor=$1,077.85

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 43332

43332 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43332

Hiatal hernia repair

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 · 43332

Hiatal hernia repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

43332 without 51 · national facility

$1,077.85

Hiatal hernia repair

43332-51 · Second procedure: 50%

$538.93

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

43332 compared with similar codes

Compare codes

43332 vs 43333 vs 43334 vs 43281 vs 43282: national Medicare rates

Swap in your local Medicare rate.

  • 43332
    Hiatal hernia repair · 19.13 wRVU
    —
  • 43333
    Hernia repair · 20.92 wRVU
    —
  • 43334
    Diaphragmatic hernia repair · 21.57 wRVU
    —
  • 43281
    Hernia repair · 25.94 wRVU
    —
  • 43282
    Hernia repair · 29.35 wRVU
    —

How to choose

43333Hernia repair
Choose 43333 rather than 43332 when fundoplasty is performed during the open transabdominal repair; both codes describe repairs without mesh.
43334Diaphragmatic hernia repair
43334 identifies a transthoracic repair without fundoplasty or mesh. 43332 identifies the transabdominal approach.
43281Hernia repair
43281 is the laparoscopic alternative for paraesophageal hernia repair without mesh; 43332 is for an open transabdominal operation.
43282Hernia repair
43282 describes laparoscopic paraesophageal hernia repair with mesh implantation. 43332 describes an open abdominal repair without mesh.

Codes related to 43332

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

Codes related to 43332
CodeHow it relatesNational office range
Same family
43333Hernia repairOpen transabdominal repair with fundoplasty and without mesh.No office rate
43334Diaphragmatic hernia repairTransthoracic repair without fundoplasty or mesh.No office rate
43335Hiatal hernia repairTransthoracic repair with fundoplasty and without mesh.No office rate
43336Hernia repairThoracoabdominal repair without fundoplasty or mesh.No office rate
43337Diaphragmatic hernia repairThoracoabdominal repair with fundoplasty and without mesh.No office rate
Used instead
43281Hernia repairLaparoscopic paraesophageal hernia repair without mesh; fundoplasty may be performed.No office rate
43282Hernia repairLaparoscopic paraesophageal hernia repair with mesh implantation.No office rate

43332 billing questions

How does 43332 differ from 43333?

43332 is for the open transabdominal repair without fundoplasty or mesh. Use 43333 when the repair includes fundoplasty and does not include mesh.

Can 43332 be used for a laparoscopic repair?

No. It identifies an open transabdominal approach. Laparoscopic paraesophageal hernia repair is represented by a different code family.

What operative details should the record support?

Document the paraesophageal hernia repair, the transabdominal approach, and whether fundoplasty or mesh was performed. Those details distinguish this code from related repair options.

Does modifier 50 apply when the hernia involves both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What postoperative care is included in the global period?

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 paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 43332PPRRVU2026_Oct_nonQPP.csv, line 5,230 (RVU26D)

Open CMS sourceHow we calculate rates

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