Billing code 43830: GastrostomyMedicare rate & RVUs in Alabama
Reports open surgical creation of gastric access without constructing a gastric tube, commonly for enteral feeding or stomach decompression.
CMS doesn’t publish an office rate for 43830 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 43830 covers
This service creates an opening from the stomach to the abdominal wall through an open abdominal operation, without fashioning a separate gastric tube from stomach tissue. The surgeon places access for purposes such as delivering enteral nutrition or decompressing the stomach. General and pediatric surgeons typically perform it in a hospital operating room when access is needed and an open approach is selected.
Report the code when the operative note supports an open approach and confirms that the surgeon did not construct a gastric tube. Document the indication, the access created, and the tube placement or intended function. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery payment is not permitted. Modifier 50 is inappropriate for this gastric procedure.
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.
43830 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $608.04 |
How the 43830 rate is calculated
Each of 43830’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 · 43830
RVUs × geographic indexes × conversion factor
Work10.58
10.58 RVUs× 1.000 GPCI
Practice expense6.98
6.98 RVUs× 1.000 GPCI
Malpractice2.68
2.68 RVUs× 1.000 GPCI
Adjusted RVUs
20.2400
Conversion factor
$33.4009
Medicare rate
$676.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43830
43830 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43830
Gastrostomy
| 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 · 43830
Gastrostomy
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
43830 without 51 · national facility
$676.03
Gastrostomy
43830-51 · Second procedure: 50%
$338.02
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%).
43830 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43832Open gastrostomy
- Use 43830 when open gastric access is created without fashioning a gastric tube from stomach tissue. Use 43832 when the surgeon constructs that tube.
- 43831Gastrostomy
- This is the neonatal-specific open gastrostomy code. Code 43830 is not the neonatal-specific choice.
- 49440Gastrostomy placement
- Code 49440 describes percutaneous tube placement with imaging guidance. Code 43830 is for creating gastric access through an open operation.
- 43246PEG placement
- Code 43246 uses an endoscope to guide percutaneous gastrostomy placement. Code 43830 describes an open surgical approach.
43830 billing questions
How does this differ from 43832?
Code 43830 describes open gastric access without constructing a gastric tube from stomach tissue. Code 43832 is the related open procedure that includes that construction.
When should 43831 be considered instead?
Code 43831 is the neonatal-specific open gastrostomy code. Select the code that matches the patient and the procedure documented, rather than using 43830 automatically for every open gastrostomy.
Is tube placement included in this service?
The reported service establishes gastric access for a tube, so routine placement associated with creating that access is part of the operation. The operative report should describe the access and the tube.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate because this gastric operation has no bilateral counterpart.
What should the operative note establish?
Document the clinical reason for access, the open approach, the gastric opening and tube access created, and whether a gastric tube was constructed from stomach tissue.
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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