Billing code 43634: Partial gastrectomyMedicare rate & RVUs in Georgia
Reports open removal of the distal stomach with Roux-en-Y reconstruction and vagotomy, when the operative plan includes this combined procedure.
CMS doesn’t publish an office rate for 43634 in Georgia.
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 43634 covers
Code 43634 represents an open distal partial gastrectomy with Roux-en-Y reconstruction and vagotomy. A general surgeon performs the operation in an operating room, removing part of the stomach and connecting the remaining stomach to the jejunum through a Roux limb. The combined approach has been used for complicated or refractory peptic ulcer disease when resection and vagotomy are selected.
The operative report should support the extent of stomach removed, the Roux-en-Y reconstruction, and the vagotomy; a partial gastrectomy with a different reconstruction or without vagotomy belongs to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this stomach procedure. 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 43634 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $2,036.98 |
| Rest Of Georgia | Unavailable | $1,974.82 |
How the 43634 rate is calculated
Each of 43634’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 · 43634
RVUs × geographic indexes × conversion factor
Work35.72
35.72 RVUs× 1.000 GPCI
Practice expense13.45
13.45 RVUs× 1.000 GPCI
Malpractice9.57
9.57 RVUs× 1.000 GPCI
Adjusted RVUs
58.7400
Conversion factor
$33.4009
Medicare rate
$1,961.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43634
43634 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43634
Partial gastrectomy
| 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 · 43634
Partial gastrectomy
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
43634 without 51 · national facility
$1,961.97
Partial gastrectomy
43634-51 · Second procedure: 50%
$980.99
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%).
43634 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43633Partial gastrectomy
- Both include distal partial gastrectomy and Roux-en-Y reconstruction. Choose 43634 when the documented procedure also includes vagotomy; choose 43633 without it.
- 43631Partial gastrectomy
- 43631 uses gastroduodenostomy reconstruction. 43634 uses Roux-en-Y reconstruction and includes vagotomy.
- 43632Partial gastrectomy
- 43632 uses gastrojejunostomy reconstruction. 43634 identifies the Roux-en-Y reconstruction with vagotomy.
- 43620Total gastrectomy
- 43620 represents total stomach removal, while 43634 is a distal partial resection with Roux-en-Y reconstruction and vagotomy.
43634 billing questions
How is 43634 distinguished from 43633?
Both describe distal partial gastrectomy with Roux-en-Y reconstruction. Code 43634 includes vagotomy; 43633 is used when the documented procedure does not include vagotomy.
Can the vagotomy be reported separately?
Vagotomy is included in the procedure represented by 43634. Do not separately report another vagotomy code for that same operative work.
What operative details support 43634?
The operative report should document distal stomach resection, Roux-en-Y reconstruction, and vagotomy. A different reconstruction or a procedure without vagotomy points to a different code.
Does the 90-day global period include postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction when performed in the same session.
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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