43842
No office rateGstr rstcv px v-banded gstp
Use 43889 for transoral endoscopic stomach plication. Code 43842 represents a surgical restrictive procedure using a different operative approach.
On this page
CMS RVU26D · Effective 2026-10-01
43889 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$718.53
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Bariatric surgery
About 43889: Transoral endoscopic sleeve gastroplasty
Reports endoscopic stomach plication performed through the mouth to reduce gastric capacity as a restrictive treatment for obesity.
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.
CMS billing rules for 43889
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.56 · 58%
- Practice expense (office) RVU7.00 · 32%
- Malpractice RVU1.99 · 9%
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.
43889 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
Code 43843 describes a surgical restrictive procedure other than the operation represented by 43842; it is not the transoral endoscopic plication reported with 43889.
No office rate
Code 43846 involves open restrictive surgery with gastric bypass. Code 43889 is an endoscopic restrictive procedure without that bypass operation.
No office rate
Code 43848 is for revision of an open gastric restrictive procedure. Use 43889 for a transoral endoscopic sleeve gastroplasty, not a revision operation.
The same code, a different location
How does Merced compare?
43889 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Modesto
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Napa
California · 43889
Office
Unavailable
Facility
$787.87
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43889
Office
Unavailable
Facility
$749.03
No comparable office rate is available.
Redding
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Rest Of California
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43889
Office
Unavailable
Facility
$740.02
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43889
Office
Unavailable
Facility
$742.16
No comparable office rate is available.
Salinas
California · 43889
Office
Unavailable
Facility
$739.13
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43889
Office
Unavailable
Facility
$747.76
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43889
Office
Unavailable
Facility
$819.54
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43889
Office
Unavailable
Facility
$817.28
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43889
Office
Unavailable
Facility
$838.44
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43889
Office
Unavailable
Facility
$829.20
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43889
Office
Unavailable
Facility
$728.58
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43889
Office
Unavailable
Facility
$748.03
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43889
Office
Unavailable
Facility
$739.51
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43889
Office
Unavailable
Facility
$754.84
No comparable office rate is available.
Stockton
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Vallejo
California · 43889
Office
Unavailable
Facility
$784.61
No comparable office rate is available.
Visalia
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Yuba City
California · 43889
Office
Unavailable
Facility
$718.53
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 43889
Office
Unavailable
Facility
$791.57
No comparable office rate is available.
Miami
Florida · 43889
Office
Unavailable
Facility
$831.00
No comparable office rate is available.
Chicago
Illinois · 43889
Office
Unavailable
Facility
$809.97
No comparable office rate is available.
Manhattan
New York · 43889
Office
Unavailable
Facility
$823.47
No comparable office rate is available.
Alaska*
Alaska · 43889
Office
Unavailable
Facility
$914.90
No comparable office rate is available.
Alabama
Alabama · 43889
Office
Unavailable
Facility
$661.72
No comparable office rate is available.
Arkansas
Arkansas · 43889
Office
Unavailable
Facility
$654.59
No comparable office rate is available.
Arizona
Arizona · 43889
Office
Unavailable
Facility
$702.97
No comparable office rate is available.
Colorado
Colorado · 43889
Office
Unavailable
Facility
$725.23
No comparable office rate is available.
Connecticut
Connecticut · 43889
Office
Unavailable
Facility
$760.14
No comparable office rate is available.
Delaware
Delaware · 43889
Office
Unavailable
Facility
$712.37
No comparable office rate is available.
Fort Lauderdale
Florida · 43889
Office
Unavailable
Facility
$776.53
No comparable office rate is available.
Rest Of Florida
Florida · 43889
Office
Unavailable
Facility
$742.94
No comparable office rate is available.
Atlanta
Georgia · 43889
Office
Unavailable
Facility
$738.15
No comparable office rate is available.
Rest Of Georgia
Georgia · 43889
Office
Unavailable
Facility
$707.30
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43889
Office
Unavailable
Facility
$723.84
No comparable office rate is available.
Iowa
Iowa · 43889
Office
Unavailable
Facility
$659.84
No comparable office rate is available.
Idaho
Idaho · 43889
Office
Unavailable
Facility
$666.06
No comparable office rate is available.
East St. Louis
Illinois · 43889
Office
Unavailable
Facility
$768.48
No comparable office rate is available.
Rest Of Illinois
Illinois · 43889
Office
Unavailable
Facility
$736.87
No comparable office rate is available.
Suburban Chicago
Illinois · 43889
Office
Unavailable
Facility
$780.35
No comparable office rate is available.
Indiana
Indiana · 43889
Office
Unavailable
Facility
$668.56
No comparable office rate is available.
Kansas
Kansas · 43889
Office
Unavailable
Facility
$664.38
No comparable office rate is available.
Kentucky
Kentucky · 43889
Office
Unavailable
Facility
$688.19
No comparable office rate is available.
New Orleans
Louisiana · 43889
Office
Unavailable
Facility
$715.03
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43889
Office
Unavailable
Facility
$690.11
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43889
Office
Unavailable
Facility
$775.04
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43889
Office
Unavailable
Facility
$725.40
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43889
Office
Unavailable
Facility
$759.32
No comparable office rate is available.
Rest Of Maryland
Maryland · 43889
Office
Unavailable
Facility
$721.34
No comparable office rate is available.
Rest Of Maine
Maine · 43889
Office
Unavailable
Facility
$675.96
No comparable office rate is available.
Southern Maine
Maine · 43889
Office
Unavailable
Facility
$693.16
No comparable office rate is available.
Detroit
Michigan · 43889
Office
Unavailable
Facility
$757.20
No comparable office rate is available.
Rest Of Michigan
Michigan · 43889
Office
Unavailable
Facility
$708.02
No comparable office rate is available.
Minnesota
Minnesota · 43889
Office
Unavailable
Facility
$679.78
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43889
Office
Unavailable
Facility
$704.00
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43889
Office
Unavailable
Facility
$708.70
No comparable office rate is available.
Rest Of Missouri
Missouri · 43889
Office
Unavailable
Facility
$685.80
No comparable office rate is available.
Mississippi
Mississippi · 43889
Office
Unavailable
Facility
$669.94
No comparable office rate is available.
Montana**
Montana · 43889
Office
Unavailable
Facility
$719.66
No comparable office rate is available.
North Carolina
North Carolina · 43889
Office
Unavailable
Facility
$680.13
No comparable office rate is available.
North Dakota**
North Dakota · 43889
Office
Unavailable
Facility
$680.31
No comparable office rate is available.
Nebraska
Nebraska · 43889
Office
Unavailable
Facility
$660.44
No comparable office rate is available.
New Hampshire
New Hampshire · 43889
Office
Unavailable
Facility
$721.07
No comparable office rate is available.
Northern Nj
New Jersey · 43889
Office
Unavailable
Facility
$788.15
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43889
Office
Unavailable
Facility
$764.53
No comparable office rate is available.
New Mexico
New Mexico · 43889
Office
Unavailable
Facility
$713.74
No comparable office rate is available.
Nevada**
Nevada · 43889
Office
Unavailable
Facility
$708.92
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43889
Office
Unavailable
Facility
$847.79
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43889
Office
Unavailable
Facility
$774.84
No comparable office rate is available.
Queens
New York · 43889
Office
Unavailable
Facility
$818.57
No comparable office rate is available.
Rest Of New York
New York · 43889
Office
Unavailable
Facility
$688.36
No comparable office rate is available.
Ohio
Ohio · 43889
Office
Unavailable
Facility
$699.98
No comparable office rate is available.
Oklahoma
Oklahoma · 43889
Office
Unavailable
Facility
$679.95
No comparable office rate is available.
Portland
Oregon · 43889
Office
Unavailable
Facility
$735.44
No comparable office rate is available.
Rest Of Oregon
Oregon · 43889
Office
Unavailable
Facility
$699.11
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43889
Office
Unavailable
Facility
$749.76
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43889
Office
Unavailable
Facility
$696.96
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43889
Office
Unavailable
Facility
$721.36
No comparable office rate is available.
Rhode Island
Rhode Island · 43889
Office
Unavailable
Facility
$728.30
No comparable office rate is available.
South Carolina
South Carolina · 43889
Office
Unavailable
Facility
$692.05
No comparable office rate is available.
South Dakota**
South Dakota · 43889
Office
Unavailable
Facility
$675.65
No comparable office rate is available.
Tennessee
Tennessee · 43889
Office
Unavailable
Facility
$667.74
No comparable office rate is available.
Austin
Texas · 43889
Office
Unavailable
Facility
$726.61
No comparable office rate is available.
Beaumont
Texas · 43889
Office
Unavailable
Facility
$694.03
No comparable office rate is available.
Brazoria
Texas · 43889
Office
Unavailable
Facility
$706.42
No comparable office rate is available.
Dallas
Texas · 43889
Office
Unavailable
Facility
$713.19
No comparable office rate is available.
Fort Worth
Texas · 43889
Office
Unavailable
Facility
$711.72
No comparable office rate is available.
Galveston
Texas · 43889
Office
Unavailable
Facility
$710.08
No comparable office rate is available.
Houston
Texas · 43889
Office
Unavailable
Facility
$746.50
No comparable office rate is available.
Rest Of Texas
Texas · 43889
Office
Unavailable
Facility
$701.42
No comparable office rate is available.
Utah
Utah · 43889
Office
Unavailable
Facility
$698.98
No comparable office rate is available.
Virginia
Virginia · 43889
Office
Unavailable
Facility
$696.27
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43889
Office
Unavailable
Facility
$721.36
No comparable office rate is available.
Vermont
Vermont · 43889
Office
Unavailable
Facility
$684.62
No comparable office rate is available.
Rest Of Washington
Washington · 43889
Office
Unavailable
Facility
$721.75
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43889
Office
Unavailable
Facility
$781.68
No comparable office rate is available.
Wisconsin
Wisconsin · 43889
Office
Unavailable
Facility
$663.97
No comparable office rate is available.
West Virginia
West Virginia · 43889
Office
Unavailable
Facility
$717.81
No comparable office rate is available.
Wyoming**
Wyoming · 43889
Office
Unavailable
Facility
$702.51
No comparable office rate is available.
See how rates vary across the country
43889 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 43889 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$790.38
$718.53 × 110% = $790.38
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43889 in Merced.
PPRRVU2026_Oct_nonQPP.csv
5,321
- Code
- 43889
- Physician work
- 12.56
- Practice expense
- 7.00
- Malpractice
- 1.99
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.56 | × 1.017 | 12.7735 |
| Practice expense | 7.00 | × 1.096 | 7.6720 |
| Malpractice | 1.99 | × 0.536 | 1.0666 |
| Total RVUs | 21.5122 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$718.53
Open 43889 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.56 | 1.017 |
| Practice expense | 7 | 1.096 |
| Malpractice | 1.99 | 0.536 |
(12.56 × 1.017 + 7 × 1.096 + 1.99 × 0.536) × $33.4009 = $718.53
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
43889 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
No ratechanged toNo rate
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: No rate
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $718.53 | RVU26D |
| 2026-07-01 | Not available in this setting | $718.53 | RVU26C |
| 2026-04-01 | Not available in this setting | $718.53 | RVU26B |
| 2026-01-01 | Not available in this setting | $718.53 | RVU26A |
| 2025-10-01 | Not in this release | Not in this release | RVU25D |
| 2025-07-01 | Not in this release | Not in this release | RVU25C |
| 2025-04-01 | Not in this release | Not in this release | RVU25B |
| 2025-01-01 | Not in this release | Not in this release | RVU25A |
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 under the CMS facts provided.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,31843886,,Gstr rstcv px opn revj port,A,,4.52,5.43,NA,5.43,,1.21,11.16,11.16,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,31943887,,Gstr rstcv px opn rmvl port,A,,4.21,4.70,NA,4.70,,1.13,10.04,10.04,0,090,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32043888,,Gstr rstcv px opn rmvl&rplc,A,,6.28,5.86,NA,5.86,,1.67,13.81,13.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32143889,,Gstr rstcv px trnsorl esg,A,,12.56,7.00,NA,7.00,,1.99,21.55,21.55,0,090,0.09,0.84,0.07,3,0,0,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
5,32243999,,Unlisted procedure stomach,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,32344005,,Freeing of bowel adhesion,A,,18.00,8.01,NA,8.01,,4.54,30.55,30.55,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,3244400F,,Rehab thxpy options w/pt,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623