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Billing code 43634: Partial gastrectomyMedicare rate & RVUs

Reports open removal of the distal stomach with Roux-en-Y reconstruction and vagotomy, when the operative plan includes this combined procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities26 Medicare services in 2024

Medicare pays $1,961.97 for 43634 nationally in a facility.

Medicare rate · 43634

Partial gastrectomy

Swap in your local Medicare rate.

Work RVUs
35.72
Total RVUs
58.74
Global days
090

National rate · 2026

$1,961.97

Facility setting, before claim adjustments.

See every locality for 43634 → · 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 43634 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 43634 covers

Code 43634 represents an open distal partial gastrectomy with Roux-en-Y reconstruction and vagotomy. A general surgeon performs the operation in an operating room, removing part of the stomach and connecting the remaining stomach to the jejunum through a Roux limb. The combined approach has been used for complicated or refractory peptic ulcer disease when resection and vagotomy are selected.

The operative report should support the extent of stomach removed, the Roux-en-Y reconstruction, and the vagotomy; a partial gastrectomy with a different reconstruction or without vagotomy belongs to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this stomach procedure. 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 43634 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

43634 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,767.09
Alaska*Unavailable$2,444.19
ArizonaUnavailable$1,902.01
ArkansasUnavailable$1,743.60
AtlantaUnavailable$2,036.98
AustinUnavailable$1,953.97
BakersfieldUnavailable$1,902.78
Baltimore/Surr. CntysUnavailable$2,089.61
BeaumontUnavailable$1,898.84
BrazoriaUnavailable$1,897.15

43634 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
43634 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 43634 rate is calculated

Each of 43634’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 · 43634

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 35.72Practice expense 13.45Malpractice 9.57

58.7400 adjusted RVUs×$33.4009 conversion factor=$1,961.97

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

Payment rules and modifiers for 43634

43634 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43634

Partial 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 · 43634

Partial 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

43634 without 51 · national facility

$1,961.97

Partial gastrectomy

43634-51 · Second procedure: 50%

$980.99

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

43634 compared with similar codes

Compare codes

43634 vs 43633 vs 43631 vs 43632 vs 43620: national Medicare rates

Swap in your local Medicare rate.

  • 43634
    Partial gastrectomy · 35.72 wRVU
    —
  • 43633
    Partial gastrectomy · 32.31 wRVU
    —
  • 43631
    Partial gastrectomy · 23.9 wRVU
    —
  • 43632
    Partial gastrectomy · 34.26 wRVU
    —
  • 43620
    Total gastrectomy · 33.19 wRVU
    —

How to choose

43633Partial gastrectomy
Both include distal partial gastrectomy and Roux-en-Y reconstruction. Choose 43634 when the documented procedure also includes vagotomy; choose 43633 without it.
43631Partial gastrectomy
43631 uses gastroduodenostomy reconstruction. 43634 uses Roux-en-Y reconstruction and includes vagotomy.
43632Partial gastrectomy
43632 uses gastrojejunostomy reconstruction. 43634 identifies the Roux-en-Y reconstruction with vagotomy.
43620Total gastrectomy
43620 represents total stomach removal, while 43634 is a distal partial resection with Roux-en-Y reconstruction and vagotomy.

Codes related to 43634

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

Codes related to 43634
CodeHow it relatesNational office range
Same family
43633Partial gastrectomyDistal partial gastrectomy with Roux-en-Y reconstruction, without the vagotomy included in 43634.No office rate
43631Partial gastrectomyDistal partial gastrectomy with gastroduodenostomy reconstruction.No office rate
43632Partial gastrectomyDistal partial gastrectomy with gastrojejunostomy reconstruction.No office rate
43635Partial gastrectomyA different partial-gastrectomy variant; distinguish by the procedure documented.No office rate
Used instead
43620Total gastrectomyTotal rather than partial stomach removal when the operative extent requires gastrectomy of the whole stomach.No office rate

43634 billing questions

How is 43634 distinguished from 43633?

Both describe distal partial gastrectomy with Roux-en-Y reconstruction. Code 43634 includes vagotomy; 43633 is used when the documented procedure does not include vagotomy.

Can the vagotomy be reported separately?

Vagotomy is included in the procedure represented by 43634. Do not separately report another vagotomy code for that same operative work.

What operative details support 43634?

The operative report should document distal stomach resection, Roux-en-Y reconstruction, and vagotomy. A different reconstruction or a procedure without vagotomy points to a different code.

Does the 90-day global period include postoperative visits?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction when performed in the same session.

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 43634PPRRVU2026_Oct_nonQPP.csv, line 5,271 (RVU26D)

Open CMS sourceHow we calculate rates

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