No office rate
Both codes describe total gastrectomy, but the reconstruction differs. Use 43620 for esophagoenterostomy and select 43621 when its distinct reconstruction matches the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
43620 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1757.17
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 43620: Total gastrectomy with bowel connection
Reports removal of the entire stomach with an esophagus-to-small-bowel connection, typically for extensive gastric disease requiring total resection.
This code describes open removal of the entire stomach followed by a connection between the esophagus and small intestine. A general surgeon or surgical oncologist may perform it for gastric cancer or other extensive gastric disease when the operative plan calls for total rather than partial removal. The reconstruction is part of the service, not a separate intestinal procedure.
Select the code when the operative report supports removal of the whole stomach and the specified esophagoenterostomy reconstruction; a partial resection or a different reconstruction points to another code. Documentation should identify the extent of resection and the reconstruction performed. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43620
- 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 RVU33.19 · 60%
- Practice expense (office) RVU12.84 · 23%
- Malpractice RVU8.89 · 16%
55
Medicare services in 2024 · #5301 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.
43620 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
43622 is a separate total gastrectomy variant. Choose between the codes based on the specific reconstruction and operative details required by the full descriptor.
No office rate
43631 describes partial distal stomach removal with reconstruction, not removal of the entire stomach. The extent of resection determines which code applies.
The same code, a different location
How does Wyoming** compare?
43620 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 · 43620
Office
Unavailable
Facility
$1651.90
No comparable office rate is available.
Arkansas
Arkansas · 43620
Office
Unavailable
Facility
$1629.89
No comparable office rate is available.
Arizona
Arizona · 43620
Office
Unavailable
Facility
$1778.32
No comparable office rate is available.
Bakersfield
California · 43620
Office
Unavailable
Facility
$1780.51
No comparable office rate is available.
Chico
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
El Centro
California · 43620
Office
Unavailable
Facility
$1758.10
No comparable office rate is available.
Fresno
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Hanford-Corcoran
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Madera
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Merced
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Modesto
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Napa
California · 43620
Office
Unavailable
Facility
$1894.51
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43620
Office
Unavailable
Facility
$1831.53
No comparable office rate is available.
Redding
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Rest Of California
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43620
Office
Unavailable
Facility
$1851.85
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43620
Office
Unavailable
Facility
$1806.41
No comparable office rate is available.
Salinas
California · 43620
Office
Unavailable
Facility
$1799.16
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43620
Office
Unavailable
Facility
$1815.70
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43620
Office
Unavailable
Facility
$1954.89
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43620
Office
Unavailable
Facility
$1944.79
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43620
Office
Unavailable
Facility
$2008.10
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43620
Office
Unavailable
Facility
$1966.83
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43620
Office
Unavailable
Facility
$1775.06
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43620
Office
Unavailable
Facility
$1812.09
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43620
Office
Unavailable
Facility
$1798.83
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43620
Office
Unavailable
Facility
$1827.64
No comparable office rate is available.
Stockton
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Vallejo
California · 43620
Office
Unavailable
Facility
$1879.96
No comparable office rate is available.
Visalia
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Yuba City
California · 43620
Office
Unavailable
Facility
$1756.62
No comparable office rate is available.
Colorado
Colorado · 43620
Office
Unavailable
Facility
$1810.10
No comparable office rate is available.
Connecticut
Connecticut · 43620
Office
Unavailable
Facility
$1951.93
No comparable office rate is available.
Delaware
Delaware · 43620
Office
Unavailable
Facility
$1804.78
No comparable office rate is available.
Fort Lauderdale
Florida · 43620
Office
Unavailable
Facility
$2079.88
No comparable office rate is available.
Rest Of Florida
Florida · 43620
Office
Unavailable
Facility
$1964.87
No comparable office rate is available.
Atlanta
Georgia · 43620
Office
Unavailable
Facility
$1904.25
No comparable office rate is available.
Rest Of Georgia
Georgia · 43620
Office
Unavailable
Facility
$1845.07
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43620
Office
Unavailable
Facility
$1768.12
No comparable office rate is available.
Iowa
Iowa · 43620
Office
Unavailable
Facility
$1618.87
No comparable office rate is available.
Idaho
Idaho · 43620
Office
Unavailable
Facility
$1643.58
No comparable office rate is available.
East St. Louis
Illinois · 43620
Office
Unavailable
Facility
$2101.16
No comparable office rate is available.
Rest Of Illinois
Illinois · 43620
Office
Unavailable
Facility
$1964.24
No comparable office rate is available.
Suburban Chicago
Illinois · 43620
Office
Unavailable
Facility
$2082.95
No comparable office rate is available.
Indiana
Indiana · 43620
Office
Unavailable
Facility
$1650.45
No comparable office rate is available.
Kansas
Kansas · 43620
Office
Unavailable
Facility
$1645.93
No comparable office rate is available.
Kentucky
Kentucky · 43620
Office
Unavailable
Facility
$1761.53
No comparable office rate is available.
New Orleans
Louisiana · 43620
Office
Unavailable
Facility
$1849.46
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43620
Office
Unavailable
Facility
$1772.59
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43620
Office
Unavailable
Facility
$1930.37
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43620
Office
Unavailable
Facility
$1814.57
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43620
Office
Unavailable
Facility
$1953.80
No comparable office rate is available.
Rest Of Maryland
Maryland · 43620
Office
Unavailable
Facility
$1826.26
No comparable office rate is available.
Rest Of Maine
Maine · 43620
Office
Unavailable
Facility
$1687.83
No comparable office rate is available.
Southern Maine
Maine · 43620
Office
Unavailable
Facility
$1720.95
No comparable office rate is available.
Detroit
Michigan · 43620
Office
Unavailable
Facility
$2023.06
No comparable office rate is available.
Rest Of Michigan
Michigan · 43620
Office
Unavailable
Facility
$1835.37
No comparable office rate is available.
Minnesota
Minnesota · 43620
Office
Unavailable
Facility
$1637.77
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43620
Office
Unavailable
Facility
$1801.39
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43620
Office
Unavailable
Facility
$1814.39
No comparable office rate is available.
Rest Of Missouri
Missouri · 43620
Office
Unavailable
Facility
$1767.47
No comparable office rate is available.
Mississippi
Mississippi · 43620
Office
Unavailable
Facility
$1697.27
No comparable office rate is available.
Montana**
Montana · 43620
Office
Unavailable
Facility
$1833.78
No comparable office rate is available.
North Carolina
North Carolina · 43620
Office
Unavailable
Facility
$1698.45
No comparable office rate is available.
North Dakota**
North Dakota · 43620
Office
Unavailable
Facility
$1658.00
No comparable office rate is available.
Nebraska
Nebraska · 43620
Office
Unavailable
Facility
$1616.66
No comparable office rate is available.
New Hampshire
New Hampshire · 43620
Office
Unavailable
Facility
$1814.84
No comparable office rate is available.
Northern Nj
New Jersey · 43620
Office
Unavailable
Facility
$1993.03
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43620
Office
Unavailable
Facility
$1946.98
No comparable office rate is available.
New Mexico
New Mexico · 43620
Office
Unavailable
Facility
$1858.47
No comparable office rate is available.
Nevada**
Nevada · 43620
Office
Unavailable
Facility
$1785.22
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43620
Office
Unavailable
Facility
$2240.85
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43620
Office
Unavailable
Facility
$1987.36
No comparable office rate is available.
Queens
New York · 43620
Office
Unavailable
Facility
$2114.63
No comparable office rate is available.
Rest Of New York
New York · 43620
Office
Unavailable
Facility
$1724.74
No comparable office rate is available.
Ohio
Ohio · 43620
Office
Unavailable
Facility
$1799.44
No comparable office rate is available.
Oklahoma
Oklahoma · 43620
Office
Unavailable
Facility
$1722.27
No comparable office rate is available.
Portland
Oregon · 43620
Office
Unavailable
Facility
$1823.70
No comparable office rate is available.
Rest Of Oregon
Oregon · 43620
Office
Unavailable
Facility
$1744.47
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43620
Office
Unavailable
Facility
$1929.22
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43620
Office
Unavailable
Facility
$1782.88
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43620
Office
Unavailable
Facility
$1834.64
No comparable office rate is available.
Rhode Island
Rhode Island · 43620
Office
Unavailable
Facility
$1837.52
No comparable office rate is available.
South Carolina
South Carolina · 43620
Office
Unavailable
Facility
$1757.24
No comparable office rate is available.
South Dakota**
South Dakota · 43620
Office
Unavailable
Facility
$1637.21
No comparable office rate is available.
Tennessee
Tennessee · 43620
Office
Unavailable
Facility
$1657.87
No comparable office rate is available.
Austin
Texas · 43620
Office
Unavailable
Facility
$1827.62
No comparable office rate is available.
Beaumont
Texas · 43620
Office
Unavailable
Facility
$1774.70
No comparable office rate is available.
Brazoria
Texas · 43620
Office
Unavailable
Facility
$1774.06
No comparable office rate is available.
Dallas
Texas · 43620
Office
Unavailable
Facility
$1800.47
No comparable office rate is available.
Fort Worth
Texas · 43620
Office
Unavailable
Facility
$1800.05
No comparable office rate is available.
Galveston
Texas · 43620
Office
Unavailable
Facility
$1789.17
No comparable office rate is available.
Houston
Texas · 43620
Office
Unavailable
Facility
$1951.89
No comparable office rate is available.
Rest Of Texas
Texas · 43620
Office
Unavailable
Facility
$1783.70
No comparable office rate is available.
Utah
Utah · 43620
Office
Unavailable
Facility
$1778.36
No comparable office rate is available.
Virginia
Virginia · 43620
Office
Unavailable
Facility
$1739.79
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43620
Office
Unavailable
Facility
$1834.64
No comparable office rate is available.
Vermont
Vermont · 43620
Office
Unavailable
Facility
$1683.40
No comparable office rate is available.
Rest Of Washington
Washington · 43620
Office
Unavailable
Facility
$1800.55
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43620
Office
Unavailable
Facility
$1932.82
No comparable office rate is available.
Wisconsin
Wisconsin · 43620
Office
Unavailable
Facility
$1610.89
No comparable office rate is available.
West Virginia
West Virginia · 43620
Office
Unavailable
Facility
$1906.17
No comparable office rate is available.
See how rates vary across the country
43620 · 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 43620 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1932.89
$1757.17 × 110% = $1932.89
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 43620 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,265
- Code
- 43620
- Physician work
- 33.19
- Practice expense
- 12.84
- Malpractice
- 8.89
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 33.19 | × 1.000 | 33.1900 |
| Practice expense | 12.84 | × 1.000 | 12.8400 |
| Malpractice | 8.89 | × 0.740 | 6.5786 |
| Total RVUs | 52.6086 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1757.17
Open 43620 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 33.19 | 1 |
| Practice expense | 12.84 | 1 |
| Malpractice | 8.89 | 0.74 |
(33.19 × 1 + 12.84 × 1 + 8.89 × 0.74) × $33.4009 = $1757.17
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
43620 · 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 | $1757.17 | RVU26D |
| 2026-07-01 | Not available in this setting | $1757.17 | RVU26C |
| 2026-04-01 | Not available in this setting | $1757.17 | RVU26B |
| 2026-01-01 | Not available in this setting | $1757.17 | RVU26A |
| 2025-10-01 | Not available in this setting | $1855.30 | RVU25D |
| 2025-07-01 | Not available in this setting | $1855.30 | RVU25C |
| 2025-04-01 | Not available in this setting | $1855.30 | RVU25B |
| 2025-01-01 | Not available in this setting | $1855.30 | RVU25A |
43620 billing questions
How is this code distinguished from a partial gastrectomy?
Use 43620 when the entire stomach is removed and the specified esophagoenterostomy reconstruction is performed. Partial removal belongs to a partial gastrectomy code.
How does 43620 differ from other total gastrectomy codes?
The total gastrectomy codes distinguish the reconstruction performed. Match the operative report to the full descriptor, including whether the reconstruction is an esophagoenterostomy or a different configuration.
Is the esophagus-to-small-bowel connection billed separately?
The esophagoenterostomy reconstruction is included in 43620. It is not separately reported as an additional service for the same operative work.
What documentation supports reporting 43620?
The operative report should establish removal of the entire stomach and describe the esophagoenterostomy reconstruction. It should also distinguish the procedure from a partial gastrectomy.
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.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,26243605,,Biopsy of stomach,A,,13.38,7.01,NA,7.01,,3.58,23.97,23.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26343610,,Excision of stomach lesion,A,,15.93,7.54,NA,7.54,,4.07,27.54,27.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26443611,,Excision of stomach lesion,A,,19.87,9.57,NA,9.57,,4.96,34.40,34.40,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26543620,,Removal of stomach,A,,33.19,12.84,NA,12.84,,8.89,54.92,54.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26643621,,Removal of stomach,A,,38.54,14.30,NA,14.30,,9.78,62.62,62.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26743622,,Removal of stomach,A,,39.03,14.26,NA,14.26,,10.46,63.75,63.75,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26843631,,Removal of stomach partial,A,,23.90,10.55,NA,10.55,,6.14,40.59,40.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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.,,,,,,