Billing code 43282: Hernia repairMedicare rate & RVUs in Florida
Reports laparoscopic repair of a paraesophageal hernia when mesh is implanted to reinforce the repair, with fundoplasty included when performed.
CMS doesn’t publish an office rate for 43282 in Florida.
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 43282 covers
A surgeon uses a laparoscope to reduce the herniated stomach and repair the opening in the diaphragm, implanting mesh to reinforce the repair. The operation is commonly performed in a hospital operating room for a paraesophageal hernia; a fundoplasty may also be performed as part of the operation. The code distinguishes a repair with mesh from the corresponding repair without mesh.
Report the service when the operative record supports laparoscopic paraesophageal hernia repair and documents mesh implantation. Fundoplasty performed as part of the repair is included. Medicare 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 other procedures are subject to the standard 50% reduction. 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.
Where 43282 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,814.45 |
| Miami | Unavailable | $2,010.09 |
| Rest Of Florida | Unavailable | $1,715.24 |
How the 43282 rate is calculated
Each of 43282’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 · 43282
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.35Practice expense 10.91Malpractice 7.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43282
43282 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43282
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 · 43282
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
43282 without 51 · national facility
$1,601.91
Hernia repair
43282-51 · Second procedure: 50%
$800.96
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%).
43282 compared with similar codes
Compare codes
43282 vs 43281 vs 43280 vs 43283: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43281Hernia repair
- Choose 43281 for laparoscopic paraesophageal hernia repair without mesh. Choose 43282 when mesh is implanted as part of the repair.
- 43280Fundoplasty
- 43280 describes laparoscopic fundoplasty for an antireflux operation. It is not the paraesophageal hernia repair code.
- 43283Esophageal lengthening
- 43283 describes laparoscopic esophageal lengthening, such as a Collis procedure. It does not substitute for the paraesophageal hernia repair code.
43282 billing questions
How does 43282 differ from 43281?
Both report laparoscopic paraesophageal hernia repair, but 43282 is for a repair with implanted mesh. Use 43281 for the corresponding repair without mesh.
Can fundoplasty be billed separately with 43282?
Fundoplasty performed as part of the paraesophageal hernia repair is included in 43282. The operative report should describe the repair and any fundoplasty performed.
What documentation supports reporting the mesh version?
The operative report should establish the laparoscopic paraesophageal hernia repair and document that mesh was implanted to reinforce the repair.
What is included in the Medicare global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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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