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Billing code 43832: Open gastrostomyMedicare rate & RVUs

Reports open abdominal gastrostomy in which the surgeon constructs a gastric tube, commonly to establish durable access for feeding or drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities340 Medicare services in 2024

Medicare pays $985.99 for 43832 nationally in a facility.

Medicare rate · 43832

Open gastrostomy

Swap in your local Medicare rate.

Work RVUs
16.91
Total RVUs
29.52
Global days
090

National rate · 2026

$985.99

Facility setting, before claim adjustments.

See every locality for 43832 → · 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 43832 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 43832 covers

A surgeon performs this operation through an abdominal incision, bringing part of the stomach to the abdominal wall and constructing a tube-like channel from gastric tissue. It may be chosen when a patient needs durable access for enteral feeding or gastric drainage and an open approach is performed. General surgeons and pediatric surgeons typically perform the procedure in an operating room; the neonatal service has a separate code.

Report this code when the operative note supports both an open approach and construction of the gastric tube. The construction is part of the reported operation, not a separate service. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 43832 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

43832 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$888.14
Alaska*Unavailable$1,220.58
ArizonaUnavailable$956.41
ArkansasUnavailable$876.28
AtlantaUnavailable$1,021.49
AustinUnavailable$986.39
BakersfieldUnavailable$965.91
Baltimore/Surr. CntysUnavailable$1,049.77
BeaumontUnavailable$950.87
BrazoriaUnavailable$955.85

43832 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
43832 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 43832 rate is calculated

Each of 43832’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 · 43832

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.91Practice expense 8.23Malpractice 4.38

29.5200 adjusted RVUs×$33.4009 conversion factor=$985.99

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

Payment rules and modifiers for 43832

43832 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43832

Open gastrostomy

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 · 43832

Open gastrostomy

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

43832 without 51 · national facility

$985.99

Open gastrostomy

43832-51 · Second procedure: 50%

$493.00

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

43832 compared with similar codes

Compare codes

43832 vs 43830 vs 43831 vs 43653 vs 49440: national Medicare rates

Swap in your local Medicare rate.

  • 43832
    Open gastrostomy · 16.91 wRVU
    —
  • 43830
    Gastrostomy · 10.58 wRVU
    —
  • 43831
    Gastrostomy · 8.28 wRVU
    —
  • 43653
    Gastrostomy · 8.27 wRVU
    —
  • 49440
    Gastrostomy placement · 3.83 wRVU
    $788.26

How to choose

43830Gastrostomy
Choose 43832 when the open operation includes construction of a gastric tube. Choose 43830 when that construction is not performed.
43831Gastrostomy
43831 is the neonatal open gastrostomy code. This code is for the non-neonatal service when a gastric tube is constructed.
43653Gastrostomy
43653 describes laparoscopic gastrostomy. This code describes an open operation with gastric tube construction.
49440Gastrostomy placement
49440 describes percutaneous, image-guided gastrostomy tube placement; this code represents an open surgical approach with gastric tube construction.

Codes related to 43832

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

Codes related to 43832
CodeHow it relatesNational office range
Same family
43830GastrostomyOpen gastrostomy without construction of a gastric tube.No office rate
43831GastrostomySeparate open gastrostomy code for neonatal patients.No office rate
Used instead
43653GastrostomyLaparoscopic approach for gastrostomy rather than an open abdominal approach.No office rate
49440Gastrostomy placementPercutaneous gastrostomy tube placement using imaging guidance.$690.21–$1,081.19

43832 billing questions

How does this differ from 43830?

Both describe open gastrostomy, but 43832 requires construction of a gastric tube. Use 43830 when the open procedure is performed without that construction.

What operative documentation supports 43832?

The operative report should establish the open approach and describe construction of the gastric tube, along with the clinical purpose, such as feeding access or drainage.

Can the gastric tube construction be billed separately?

No. The construction is included in this gastrostomy service; it is not a separately reported component.

Does modifier 50 apply to this code?

No. CMS identifies bilateral adjustment as inappropriate for this procedure.

What postoperative care is included?

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 reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is provided.

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 43832PPRRVU2026_Oct_nonQPP.csv, line 5,304 (RVU26D)

Open CMS sourceHow we calculate rates

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