Billing code 43335: Hiatal hernia repairMedicare rate & RVUs in Alabama
Reports transthoracic repair of a paraesophageal hiatal hernia using mesh, including fundoplication when performed as part of the repair.
CMS doesn’t publish an office rate for 43335 in Alabama.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 43335 covers
This code describes repair of a paraesophageal hiatal hernia through a thoracic approach with mesh reinforcement; fundoplication is included when performed as part of the repair. A thoracic or general surgeon typically performs the operation in a hospital operating room, often for a large or complex hernia requiring access through the chest. The operative report should establish the hernia being repaired, the transthoracic route, and mesh use.
Select this code for the thoracic approach with mesh, rather than the corresponding thoracic repair without mesh or an abdominal approach. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, CMS pays the highest-valued procedure in full and others at 50%. Report this as a single repair, not with modifier 50. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
43335 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $1,133.14 |
How the 43335 rate is calculated
Each of 43335’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43335
RVUs × geographic indexes × conversion factor
Work23.37
23.37 RVUs× 1.000 GPCI
Practice expense8.26
8.26 RVUs× 1.000 GPCI
Malpractice5.88
5.88 RVUs× 1.000 GPCI
Adjusted RVUs
37.5100
Conversion factor
$33.4009
Medicare rate
$1,252.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43335
43335 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43335
Hiatal hernia repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43335
Hiatal hernia repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43335 without 51 · national facility
$1,252.87
Hiatal hernia repair
43335-51 · Second procedure: 50%
$626.44
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43335 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43334Diaphragmatic hernia repair
- Both use a transthoracic approach for paraesophageal hernia repair. Choose 43335 when mesh is used and 43334 when it is not.
- 43332Hiatal hernia repair
- This code is for the abdominal approach without mesh. The transthoracic approach with mesh is reported with 43335.
- 43333Hernia repair
- This code is for abdominal-approach repair with mesh. The approach, not mesh use alone, distinguishes it from 43335.
43335 billing questions
How does this differ from 43334?
Both describe transthoracic paraesophageal hernia repair; 43335 includes mesh, while 43334 is the corresponding repair without mesh. The operative report should support which was performed.
When should the abdominal-approach codes be considered?
Use the abdominal-approach family when the repair is performed through the abdomen. Codes 43332 and 43333 distinguish the abdominal approach without and with mesh, respectively.
Is fundoplication separately reported with this repair?
Fundoplication is included when performed as part of the paraesophageal hernia repair. The operative documentation should describe the repair and any fundoplication performed.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy; report the repair as a single procedure rather than appending modifier 50.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
How are assistant and co-surgeon services handled?
An assistant at surgery may be paid. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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