No office rate
Use 43284 for laparoscopic magnetic device placement. Use 43280 when the surgeon performs laparoscopic fundoplasty instead.
On this page
CMS RVU26D · Effective 2026-10-01
43284 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$603.76
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.
Digestive surgery
About 43284: Laparoscopic magnetic sphincter augmentation
Reports laparoscopic placement of a magnetic device around the lower esophageal sphincter to treat gastroesophageal reflux disease.
A surgeon places a ring of magnetic beads around the lower esophagus at the lower esophageal sphincter. The device is intended to strengthen the barrier against reflux while allowing food and liquid to pass. This procedure is typically performed laparoscopically by a general or foregut surgeon in a hospital or ambulatory surgery setting for a patient with gastroesophageal reflux disease.
Report the service when the operative record supports laparoscopic placement of the sphincter augmentation device; documentation should identify the procedure and device placement. A separately performed paraesophageal hernia repair may be reported when supported by the operative work and documentation. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this procedure. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43284
- 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 RVU9.88 · 53%
- Practice expense (office) RVU6.25 · 33%
- Malpractice RVU2.63 · 14%
83
Medicare services in 2024 · #5020 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.
43284 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
This code describes laparoscopic paraesophageal hernia repair without mesh, not magnetic sphincter augmentation.
No office rate
This code describes laparoscopic paraesophageal hernia repair with mesh. It does not report placement of the magnetic augmentation device.
No office rate
43285 reports laparoscopic removal of an esophageal sphincter augmentation device; 43284 reports device placement.
The same code, a different location
How does Wyoming** compare?
43284 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
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.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming 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
Alabama
Alabama · 43284
Office
Unavailable
Facility
$562.38
No comparable office rate is available.
Arkansas
Arkansas · 43284
Office
Unavailable
Facility
$554.56
No comparable office rate is available.
Arizona
Arizona · 43284
Office
Unavailable
Facility
$607.48
No comparable office rate is available.
Bakersfield
California · 43284
Office
Unavailable
Facility
$618.56
No comparable office rate is available.
Chico
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
El Centro
California · 43284
Office
Unavailable
Facility
$611.93
No comparable office rate is available.
Fresno
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Hanford-Corcoran
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Madera
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Merced
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Modesto
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Napa
California · 43284
Office
Unavailable
Facility
$670.56
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43284
Office
Unavailable
Facility
$640.72
No comparable office rate is available.
Redding
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Rest Of California
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43284
Office
Unavailable
Facility
$639.67
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43284
Office
Unavailable
Facility
$631.75
No comparable office rate is available.
Salinas
California · 43284
Office
Unavailable
Facility
$629.26
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43284
Office
Unavailable
Facility
$637.18
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43284
Office
Unavailable
Facility
$696.02
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43284
Office
Unavailable
Facility
$693.03
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43284
Office
Unavailable
Facility
$714.41
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43284
Office
Unavailable
Facility
$702.20
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43284
Office
Unavailable
Facility
$620.47
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43284
Office
Unavailable
Facility
$637.65
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43284
Office
Unavailable
Facility
$629.73
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43284
Office
Unavailable
Facility
$643.34
No comparable office rate is available.
Stockton
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Vallejo
California · 43284
Office
Unavailable
Facility
$666.25
No comparable office rate is available.
Visalia
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Yuba City
California · 43284
Office
Unavailable
Facility
$611.49
No comparable office rate is available.
Colorado
Colorado · 43284
Office
Unavailable
Facility
$624.68
No comparable office rate is available.
Connecticut
Connecticut · 43284
Office
Unavailable
Facility
$667.72
No comparable office rate is available.
Delaware
Delaware · 43284
Office
Unavailable
Facility
$616.87
No comparable office rate is available.
Fort Lauderdale
Florida · 43284
Office
Unavailable
Facility
$700.29
No comparable office rate is available.
Rest Of Florida
Florida · 43284
Office
Unavailable
Facility
$661.60
No comparable office rate is available.
Atlanta
Georgia · 43284
Office
Unavailable
Facility
$648.59
No comparable office rate is available.
Rest Of Georgia
Georgia · 43284
Office
Unavailable
Facility
$620.92
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43284
Office
Unavailable
Facility
$618.22
No comparable office rate is available.
Iowa
Iowa · 43284
Office
Unavailable
Facility
$555.89
No comparable office rate is available.
Idaho
Idaho · 43284
Office
Unavailable
Facility
$563.61
No comparable office rate is available.
East St. Louis
Illinois · 43284
Office
Unavailable
Facility
$698.97
No comparable office rate is available.
Rest Of Illinois
Illinois · 43284
Office
Unavailable
Facility
$657.90
No comparable office rate is available.
Suburban Chicago
Illinois · 43284
Office
Unavailable
Facility
$702.36
No comparable office rate is available.
Indiana
Indiana · 43284
Office
Unavailable
Facility
$566.21
No comparable office rate is available.
Kansas
Kansas · 43284
Office
Unavailable
Facility
$562.99
No comparable office rate is available.
Kentucky
Kentucky · 43284
Office
Unavailable
Facility
$595.96
No comparable office rate is available.
New Orleans
Louisiana · 43284
Office
Unavailable
Facility
$626.23
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43284
Office
Unavailable
Facility
$598.90
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43284
Office
Unavailable
Facility
$670.97
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43284
Office
Unavailable
Facility
$625.11
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43284
Office
Unavailable
Facility
$667.94
No comparable office rate is available.
Rest Of Maryland
Maryland · 43284
Office
Unavailable
Facility
$625.20
No comparable office rate is available.
Rest Of Maine
Maine · 43284
Office
Unavailable
Facility
$576.70
No comparable office rate is available.
Southern Maine
Maine · 43284
Office
Unavailable
Facility
$592.31
No comparable office rate is available.
Detroit
Michigan · 43284
Office
Unavailable
Facility
$679.56
No comparable office rate is available.
Rest Of Michigan
Michigan · 43284
Office
Unavailable
Facility
$619.77
No comparable office rate is available.
Minnesota
Minnesota · 43284
Office
Unavailable
Facility
$570.81
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43284
Office
Unavailable
Facility
$611.85
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43284
Office
Unavailable
Facility
$616.76
No comparable office rate is available.
Rest Of Missouri
Missouri · 43284
Office
Unavailable
Facility
$595.51
No comparable office rate is available.
Mississippi
Mississippi · 43284
Office
Unavailable
Facility
$574.66
No comparable office rate is available.
Montana**
Montana · 43284
Office
Unavailable
Facility
$626.43
No comparable office rate is available.
North Carolina
North Carolina · 43284
Office
Unavailable
Facility
$580.90
No comparable office rate is available.
North Dakota**
North Dakota · 43284
Office
Unavailable
Facility
$574.42
No comparable office rate is available.
Nebraska
Nebraska · 43284
Office
Unavailable
Facility
$555.89
No comparable office rate is available.
New Hampshire
New Hampshire · 43284
Office
Unavailable
Facility
$624.18
No comparable office rate is available.
Northern Nj
New Jersey · 43284
Office
Unavailable
Facility
$686.77
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43284
Office
Unavailable
Facility
$667.53
No comparable office rate is available.
New Mexico
New Mexico · 43284
Office
Unavailable
Facility
$626.93
No comparable office rate is available.
Nevada**
Nevada · 43284
Office
Unavailable
Facility
$612.14
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43284
Office
Unavailable
Facility
$762.46
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43284
Office
Unavailable
Facility
$679.73
No comparable office rate is available.
Queens
New York · 43284
Office
Unavailable
Facility
$724.54
No comparable office rate is available.
Rest Of New York
New York · 43284
Office
Unavailable
Facility
$590.07
No comparable office rate is available.
Ohio
Ohio · 43284
Office
Unavailable
Facility
$609.14
No comparable office rate is available.
Oklahoma
Oklahoma · 43284
Office
Unavailable
Facility
$584.67
No comparable office rate is available.
Portland
Oregon · 43284
Office
Unavailable
Facility
$632.56
No comparable office rate is available.
Rest Of Oregon
Oregon · 43284
Office
Unavailable
Facility
$599.68
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43284
Office
Unavailable
Facility
$658.05
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43284
Office
Unavailable
Facility
$604.65
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43284
Office
Unavailable
Facility
$627.58
No comparable office rate is available.
Rhode Island
Rhode Island · 43284
Office
Unavailable
Facility
$630.27
No comparable office rate is available.
South Carolina
South Carolina · 43284
Office
Unavailable
Facility
$597.56
No comparable office rate is available.
South Dakota**
South Dakota · 43284
Office
Unavailable
Facility
$568.27
No comparable office rate is available.
Tennessee
Tennessee · 43284
Office
Unavailable
Facility
$566.93
No comparable office rate is available.
Austin
Texas · 43284
Office
Unavailable
Facility
$629.35
No comparable office rate is available.
Beaumont
Texas · 43284
Office
Unavailable
Facility
$601.58
No comparable office rate is available.
Brazoria
Texas · 43284
Office
Unavailable
Facility
$608.04
No comparable office rate is available.
Dallas
Texas · 43284
Office
Unavailable
Facility
$616.26
No comparable office rate is available.
Fort Worth
Texas · 43284
Office
Unavailable
Facility
$615.32
No comparable office rate is available.
Galveston
Texas · 43284
Office
Unavailable
Facility
$612.67
No comparable office rate is available.
Houston
Texas · 43284
Office
Unavailable
Facility
$660.81
No comparable office rate is available.
Rest Of Texas
Texas · 43284
Office
Unavailable
Facility
$607.43
No comparable office rate is available.
Utah
Utah · 43284
Office
Unavailable
Facility
$605.12
No comparable office rate is available.
Virginia
Virginia · 43284
Office
Unavailable
Facility
$597.23
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43284
Office
Unavailable
Facility
$627.58
No comparable office rate is available.
Vermont
Vermont · 43284
Office
Unavailable
Facility
$581.12
No comparable office rate is available.
Rest Of Washington
Washington · 43284
Office
Unavailable
Facility
$620.96
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43284
Office
Unavailable
Facility
$674.41
No comparable office rate is available.
Wisconsin
Wisconsin · 43284
Office
Unavailable
Facility
$557.04
No comparable office rate is available.
West Virginia
West Virginia · 43284
Office
Unavailable
Facility
$637.11
No comparable office rate is available.
See how rates vary across the country
43284 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 43284 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$664.14
$603.76 × 110% = $664.14
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 43284 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,208
- Code
- 43284
- Physician work
- 9.88
- Practice expense
- 6.25
- Malpractice
- 2.63
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.88 | × 1.000 | 9.8800 |
| Practice expense | 6.25 | × 1.000 | 6.2500 |
| Malpractice | 2.63 | × 0.740 | 1.9462 |
| Total RVUs | 18.0762 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$603.76
Open 43284 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.88 | 1 |
| Practice expense | 6.25 | 1 |
| Malpractice | 2.63 | 0.74 |
(9.88 × 1 + 6.25 × 1 + 2.63 × 0.74) × $33.4009 = $603.76
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
43284 · 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 | $603.76 | RVU26D |
| 2026-07-01 | Not available in this setting | $603.76 | RVU26C |
| 2026-04-01 | Not available in this setting | $603.76 | RVU26B |
| 2026-01-01 | Not available in this setting | $603.76 | RVU26A |
| 2025-10-01 | Not available in this setting | $619.24 | RVU25D |
| 2025-07-01 | Not available in this setting | $619.24 | RVU25C |
| 2025-04-01 | Not available in this setting | $619.24 | RVU25B |
| 2025-01-01 | Not available in this setting | $619.24 | RVU25A |
43284 billing questions
How is 43284 different from laparoscopic fundoplasty code 43280?
43284 reports placement of a magnetic sphincter augmentation device. Code 43280 reports laparoscopic fundoplasty, a different surgical approach to reflux treatment.
Can a paraesophageal hernia repair be reported with 43284?
A distinct repair may be reported when performed and documented in addition to device placement. Codes 43281 and 43282 distinguish repair without and with mesh, respectively.
Should modifier 50 be appended?
No. This procedure is not reported bilaterally, and modifier 50 is inappropriate.
What supports reporting 43284?
The operative report should establish the laparoscopic procedure and placement of the magnetic augmentation device. Documentation of a separate hernia repair should describe that additional operative work.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The code also has a 90-day global period.
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.
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.
5,20543281,,Lap paraesophag hern repair,A,,25.94,9.97,NA,9.97,,6.75,42.66,42.66,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20643282,,Lap paraesoph her rpr w/mesh,A,,29.35,10.91,NA,10.91,,7.70,47.96,47.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20743283,,Lap esoph lengthening,A,,2.88,0.64,NA,0.64,,0.73,4.25,4.25,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20843284,,Laps esophgl sphnctr agmntj,A,,9.88,6.25,NA,6.25,,2.63,18.76,18.76,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20943285,,Rmvl esophgl sphnctr dev,A,,10.21,6.33,NA,6.33,,2.73,19.27,19.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21043286,,Esphg tot w/laps moblj,A,,53.63,20.84,NA,20.84,,13.71,88.18,88.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21143287,,Esphg dstl 2/3 w/laps moblj,A,,61.43,21.65,NA,21.65,,15.54,98.62,98.62,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,