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Billing code 43620: Total gastrectomyMedicare rate & RVUs

Reports removal of the entire stomach with an esophagus-to-small-bowel connection, typically for extensive gastric disease requiring total resection.

CMS RVU26DEffective Oct 1, 2026109 payment localities55 Medicare services in 2024

Medicare pays $1,834.38 for 43620 nationally in a facility.

Medicare rate · 43620

Total gastrectomy

Swap in your local Medicare rate.

Work RVUs
33.19
Total RVUs
54.92
Global days
090

National rate · 2026

$1,834.38

Facility setting, before claim adjustments.

See every locality for 43620 → · 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 43620 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 43620 covers

This code describes open removal of the entire stomach followed by a connection between the esophagus and small intestine. A general surgeon or surgical oncologist may perform it for gastric cancer or other extensive gastric disease when the operative plan calls for total rather than partial removal. The reconstruction is part of the service, not a separate intestinal procedure.

Select the code when the operative report supports removal of the whole stomach and the specified esophagoenterostomy reconstruction; a partial resection or a different reconstruction points to another code. Documentation should identify the extent of resection and the reconstruction performed. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be made; 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 43620 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

43620 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,651.90
Alaska*Unavailable$2,283.22
ArizonaUnavailable$1,778.32
ArkansasUnavailable$1,629.89
AtlantaUnavailable$1,904.25
AustinUnavailable$1,827.62
BakersfieldUnavailable$1,780.51
Baltimore/Surr. CntysUnavailable$1,953.80
BeaumontUnavailable$1,774.70
BrazoriaUnavailable$1,774.06

43620 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
43620 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 43620 rate is calculated

Each of 43620’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 · 43620

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 33.19Practice expense 12.84Malpractice 8.89

54.9200 adjusted RVUs×$33.4009 conversion factor=$1,834.38

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

Payment rules and modifiers for 43620

43620 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43620

Total gastrectomy

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 · 43620

Total gastrectomy

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

43620 without 51 · national facility

$1,834.38

Total gastrectomy

43620-51 · Second procedure: 50%

$917.19

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

43620 compared with similar codes

Compare codes

43620 vs 43621 vs 43622 vs 43631: national Medicare rates

Swap in your local Medicare rate.

  • 43620
    Total gastrectomy · 33.19 wRVU
    —
  • 43621
    Total gastrectomy · 38.54 wRVU
    —
  • 43622
    Total gastrectomy · 39.03 wRVU
    —
  • 43631
    Partial gastrectomy · 23.9 wRVU
    —

How to choose

43621Total gastrectomy
Both codes describe total gastrectomy, but the reconstruction differs. Use 43620 for esophagoenterostomy and select 43621 when its distinct reconstruction matches the operative report.
43622Total gastrectomy
43622 is a separate total gastrectomy variant. Choose between the codes based on the specific reconstruction and operative details required by the full descriptor.
43631Partial gastrectomy
43631 describes partial distal stomach removal with reconstruction, not removal of the entire stomach. The extent of resection determines which code applies.

Codes related to 43620

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

Codes related to 43620
CodeHow it relatesNational office range
Same family
43621Total gastrectomyTotal gastrectomy sibling distinguished by its reconstruction.No office rate
43622Total gastrectomyAnother total gastrectomy code; select by the reconstruction documented.No office rate
Used instead
43631Partial gastrectomyFor partial distal gastrectomy rather than removal of the entire stomach.No office rate

43620 billing questions

How is this code distinguished from a partial gastrectomy?

Use 43620 when the entire stomach is removed and the specified esophagoenterostomy reconstruction is performed. Partial removal belongs to a partial gastrectomy code.

How does 43620 differ from other total gastrectomy codes?

The total gastrectomy codes distinguish the reconstruction performed. Match the operative report to the full descriptor, including whether the reconstruction is an esophagoenterostomy or a different configuration.

Is the esophagus-to-small-bowel connection billed separately?

The esophagoenterostomy reconstruction is included in 43620. It is not separately reported as an additional service for the same operative work.

What documentation supports reporting 43620?

The operative report should establish removal of the entire stomach and describe the esophagoenterostomy reconstruction. It should also distinguish the procedure from a partial gastrectomy.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does the 90-day global period affect postoperative billing?

The global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 43620PPRRVU2026_Oct_nonQPP.csv, line 5,265 (RVU26D)

Open CMS sourceHow we calculate rates

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