43800
No office ratePyloroplasty
Pyloroplasty enlarges the pyloric outlet; this code is for suture repair of a perforated gastric or duodenal ulcer, wound, or injury.
On this page
CMS RVU26D · Effective 2026-10-01
43840 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1228.83
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.
Gastrointestinal surgery
About 43840: Suture repair of gastric or duodenal perforation
Reports operative suture repair of a perforated gastric or duodenal ulcer, wound, or injury when the surgeon closes the defect directly.
A surgeon uses this service to close a perforation in the stomach or duodenum caused by an ulcer, wound, or injury. It is typically performed by a general or acute care surgeon in a hospital operating room, often for an urgent abdominal presentation. The operative report should identify the affected organ, the cause and location of the defect, and the suture repair performed. This code describes direct repair, not a bypass or anastomosis created to reconstruct the upper gastrointestinal tract.
Report the code when the operative work is suture closure of the qualifying defect. CMS assigns 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 others at 50%. Bilateral adjustment is not made; modifier 50 is inappropriate. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43840
- 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
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU22.26 · 58%
- Practice expense (office) RVU10.11 · 27%
- Malpractice RVU5.73 · 15%
4.5K
Medicare services in 2024 · #1943 by national volume
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.
43840 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
Gastroduodenostomy creates a connection between the stomach and duodenum. Use this code for direct suture closure of a qualifying perforation.
No office rate
Gastrojejunostomy creates a connection between the stomach and jejunum. It is not the code for direct suture repair of a perforation.
No office rate
This code revises a gastrojejunal anastomosis without vagotomy; it does not describe primary suture closure of a gastric or duodenal perforation.
The same code, a different location
How does Modesto compare?
43840 across payment areas
Same release and payment basis · bars start at $0
Modesto · 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 · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Merced
California · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Napa
California · 43840
Office
Unavailable
Facility
$1332.64
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43840
Office
Unavailable
Facility
$1282.70
No comparable office rate is available.
Redding
California · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Rest Of California
California · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43840
Office
Unavailable
Facility
$1290.24
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43840
Office
Unavailable
Facility
$1265.58
No comparable office rate is available.
Salinas
California · 43840
Office
Unavailable
Facility
$1260.51
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43840
Office
Unavailable
Facility
$1273.41
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43840
Office
Unavailable
Facility
$1378.12
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43840
Office
Unavailable
Facility
$1371.61
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43840
Office
Unavailable
Facility
$1414.81
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43840
Office
Unavailable
Facility
$1388.21
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43840
Office
Unavailable
Facility
$1243.35
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43840
Office
Unavailable
Facility
$1271.99
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43840
Office
Unavailable
Facility
$1260.64
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43840
Office
Unavailable
Facility
$1283.07
No comparable office rate is available.
Stockton
California · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Vallejo
California · 43840
Office
Unavailable
Facility
$1323.26
No comparable office rate is available.
Visalia
California · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Yuba City
California · 43840
Office
Unavailable
Facility
$1228.83
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 43840
Office
Unavailable
Facility
$1394.46
No comparable office rate is available.
Miami
Florida · 43840
Office
Unavailable
Facility
$1579.05
No comparable office rate is available.
Chicago
Illinois · 43840
Office
Unavailable
Facility
$1527.31
No comparable office rate is available.
Manhattan
New York · 43840
Office
Unavailable
Facility
$1487.02
No comparable office rate is available.
Alaska*
Alaska · 43840
Office
Unavailable
Facility
$1580.34
No comparable office rate is available.
Alabama
Alabama · 43840
Office
Unavailable
Facility
$1147.30
No comparable office rate is available.
Arkansas
Arkansas · 43840
Office
Unavailable
Facility
$1132.14
No comparable office rate is available.
Arizona
Arizona · 43840
Office
Unavailable
Facility
$1234.55
No comparable office rate is available.
Colorado
Colorado · 43840
Office
Unavailable
Facility
$1261.19
No comparable office rate is available.
Connecticut
Connecticut · 43840
Office
Unavailable
Facility
$1353.64
No comparable office rate is available.
Delaware
Delaware · 43840
Office
Unavailable
Facility
$1252.91
No comparable office rate is available.
Fort Lauderdale
Florida · 43840
Office
Unavailable
Facility
$1431.60
No comparable office rate is available.
Rest Of Florida
Florida · 43840
Office
Unavailable
Facility
$1353.98
No comparable office rate is available.
Atlanta
Georgia · 43840
Office
Unavailable
Facility
$1318.68
No comparable office rate is available.
Rest Of Georgia
Georgia · 43840
Office
Unavailable
Facility
$1272.85
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43840
Office
Unavailable
Facility
$1238.26
No comparable office rate is available.
Iowa
Iowa · 43840
Office
Unavailable
Facility
$1128.46
No comparable office rate is available.
Idaho
Idaho · 43840
Office
Unavailable
Facility
$1144.70
No comparable office rate is available.
East St. Louis
Illinois · 43840
Office
Unavailable
Facility
$1439.63
No comparable office rate is available.
Rest Of Illinois
Illinois · 43840
Office
Unavailable
Facility
$1350.95
No comparable office rate is available.
Suburban Chicago
Illinois · 43840
Office
Unavailable
Facility
$1434.65
No comparable office rate is available.
Indiana
Indiana · 43840
Office
Unavailable
Facility
$1149.55
No comparable office rate is available.
Kansas
Kansas · 43840
Office
Unavailable
Facility
$1145.23
No comparable office rate is available.
Kentucky
Kentucky · 43840
Office
Unavailable
Facility
$1218.82
No comparable office rate is available.
New Orleans
Louisiana · 43840
Office
Unavailable
Facility
$1278.68
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43840
Office
Unavailable
Facility
$1225.70
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43840
Office
Unavailable
Facility
$1347.52
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43840
Office
Unavailable
Facility
$1263.52
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43840
Office
Unavailable
Facility
$1354.48
No comparable office rate is available.
Rest Of Maryland
Maryland · 43840
Office
Unavailable
Facility
$1268.37
No comparable office rate is available.
Rest Of Maine
Maine · 43840
Office
Unavailable
Facility
$1173.22
No comparable office rate is available.
Southern Maine
Maine · 43840
Office
Unavailable
Facility
$1198.91
No comparable office rate is available.
Detroit
Michigan · 43840
Office
Unavailable
Facility
$1392.05
No comparable office rate is available.
Rest Of Michigan
Michigan · 43840
Office
Unavailable
Facility
$1267.88
No comparable office rate is available.
Minnesota
Minnesota · 43840
Office
Unavailable
Facility
$1147.63
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43840
Office
Unavailable
Facility
$1247.57
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43840
Office
Unavailable
Facility
$1256.75
No comparable office rate is available.
Rest Of Missouri
Missouri · 43840
Office
Unavailable
Facility
$1221.00
No comparable office rate is available.
Mississippi
Mississippi · 43840
Office
Unavailable
Facility
$1175.68
No comparable office rate is available.
Montana**
Montana · 43840
Office
Unavailable
Facility
$1272.19
No comparable office rate is available.
North Carolina
North Carolina · 43840
Office
Unavailable
Facility
$1180.86
No comparable office rate is available.
North Dakota**
North Dakota · 43840
Office
Unavailable
Facility
$1158.89
No comparable office rate is available.
Nebraska
Nebraska · 43840
Office
Unavailable
Facility
$1127.53
No comparable office rate is available.
New Hampshire
New Hampshire · 43840
Office
Unavailable
Facility
$1262.50
No comparable office rate is available.
Northern Nj
New Jersey · 43840
Office
Unavailable
Facility
$1386.46
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43840
Office
Unavailable
Facility
$1351.95
No comparable office rate is available.
New Mexico
New Mexico · 43840
Office
Unavailable
Facility
$1283.02
No comparable office rate is available.
Nevada**
Nevada · 43840
Office
Unavailable
Facility
$1240.95
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43840
Office
Unavailable
Facility
$1548.00
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43840
Office
Unavailable
Facility
$1378.30
No comparable office rate is available.
Queens
New York · 43840
Office
Unavailable
Facility
$1466.21
No comparable office rate is available.
Rest Of New York
New York · 43840
Office
Unavailable
Facility
$1198.85
No comparable office rate is available.
Ohio
Ohio · 43840
Office
Unavailable
Facility
$1244.73
No comparable office rate is available.
Oklahoma
Oklahoma · 43840
Office
Unavailable
Facility
$1193.76
No comparable office rate is available.
Portland
Oregon · 43840
Office
Unavailable
Facility
$1272.96
No comparable office rate is available.
Rest Of Oregon
Oregon · 43840
Office
Unavailable
Facility
$1214.38
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43840
Office
Unavailable
Facility
$1336.74
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43840
Office
Unavailable
Facility
$1234.36
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43840
Office
Unavailable
Facility
$1273.42
No comparable office rate is available.
Rhode Island
Rhode Island · 43840
Office
Unavailable
Facility
$1277.17
No comparable office rate is available.
South Carolina
South Carolina · 43840
Office
Unavailable
Facility
$1218.20
No comparable office rate is available.
South Dakota**
South Dakota · 43840
Office
Unavailable
Facility
$1145.49
No comparable office rate is available.
Tennessee
Tennessee · 43840
Office
Unavailable
Facility
$1153.23
No comparable office rate is available.
Austin
Texas · 43840
Office
Unavailable
Facility
$1271.83
No comparable office rate is available.
Beaumont
Texas · 43840
Office
Unavailable
Facility
$1228.59
No comparable office rate is available.
Brazoria
Texas · 43840
Office
Unavailable
Facility
$1233.38
No comparable office rate is available.
Dallas
Texas · 43840
Office
Unavailable
Facility
$1250.74
No comparable office rate is available.
Fort Worth
Texas · 43840
Office
Unavailable
Facility
$1249.85
No comparable office rate is available.
Galveston
Texas · 43840
Office
Unavailable
Facility
$1243.24
No comparable office rate is available.
Houston
Texas · 43840
Office
Unavailable
Facility
$1348.12
No comparable office rate is available.
Rest Of Texas
Texas · 43840
Office
Unavailable
Facility
$1236.79
No comparable office rate is available.
Utah
Utah · 43840
Office
Unavailable
Facility
$1232.79
No comparable office rate is available.
Virginia
Virginia · 43840
Office
Unavailable
Facility
$1210.57
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43840
Office
Unavailable
Facility
$1273.42
No comparable office rate is available.
Vermont
Vermont · 43840
Office
Unavailable
Facility
$1174.65
No comparable office rate is available.
Rest Of Washington
Washington · 43840
Office
Unavailable
Facility
$1254.40
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43840
Office
Unavailable
Facility
$1351.38
No comparable office rate is available.
Wisconsin
Wisconsin · 43840
Office
Unavailable
Facility
$1125.95
No comparable office rate is available.
West Virginia
West Virginia · 43840
Office
Unavailable
Facility
$1310.83
No comparable office rate is available.
Wyoming**
Wyoming · 43840
Office
Unavailable
Facility
$1222.81
No comparable office rate is available.
See how rates vary across the country
43840 · 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?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 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 43840 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1351.71
$1228.83 × 110% = $1351.71
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 43840 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
5,305
- Code
- 43840
- Physician work
- 22.26
- Practice expense
- 10.11
- Malpractice
- 5.73
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.26 | × 1.017 | 22.6384 |
| Practice expense | 10.11 | × 1.096 | 11.0806 |
| Malpractice | 5.73 | × 0.536 | 3.0713 |
| Total RVUs | 36.7903 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$1228.83
Open 43840 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.26 | 1.017 |
| Practice expense | 10.11 | 1.096 |
| Malpractice | 5.73 | 0.536 |
(22.26 × 1.017 + 10.11 × 1.096 + 5.73 × 0.536) × $33.4009 = $1228.83
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
43840 · 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
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 | $1228.83 | RVU26D |
| 2026-07-01 | Not available in this setting | $1228.83 | RVU26C |
| 2026-04-01 | Not available in this setting | $1228.83 | RVU26B |
| 2026-01-01 | Not available in this setting | $1228.83 | RVU26A |
| 2025-10-01 | Not available in this setting | $1295.90 | RVU25D |
| 2025-07-01 | Not available in this setting | $1295.90 | RVU25C |
| 2025-04-01 | Not available in this setting | $1295.90 | RVU25B |
| 2025-01-01 | Not available in this setting | $1295.90 | RVU25A |
43840 billing questions
When should I report this instead of a gastrojejunostomy?
Report this code for direct suture closure of a gastric or duodenal perforation. A gastrojejunostomy describes creation of a connection between the stomach and jejunum, not direct closure.
What operative documentation supports this code?
The report should identify the stomach or duodenum, describe the ulcer, wound, or injury and its perforation, and document the suture repair.
Does the code have a postoperative global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used?
No. CMS does not apply a bilateral adjustment to this code, and modifier 50 is inappropriate.
How are other same-session procedures paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
Can this be billed as team surgery?
No. CMS does not permit team surgery for this code.
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.
5,30243830,,Gstrst open wo constj tube,A,,10.58,6.98,NA,6.98,,2.68,20.24,20.24,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30343831,,Gastrostomy open neonatal,A,,8.28,7.45,NA,7.45,,2.20,17.93,17.93,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30443832,,Gstrst open w/constj tube,A,,16.91,8.23,NA,8.23,,4.38,29.52,29.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30543840,,Gstrrphy sutr duol/gstr ulcr,A,,22.26,10.11,NA,10.11,,5.73,38.10,38.10,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30643842,,Gstr rstcv px v-banded gstp,N,+,20.50,7.80,NA,7.80,,2.19,30.49,30.49,9,090,0.09,0.81,0.10,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30743843,,Gstr rstcv oth/thn v-band,A,,20.68,9.91,NA,9.91,,5.53,36.12,36.12,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30843845,,Gastroplasty duodenal switch,A,,32.47,13.66,NA,13.66,,8.57,54.70,54.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
1901112,CA,61,REDDING,1.017,1.096,0.536