Billing code 43328: FundoplastyMedicare rate & RVUs in Guam
Reports an antireflux fundoplasty performed through a thoracic approach, with the stomach’s upper portion wrapped around the distal esophagus.
CMS doesn’t publish an office rate for 43328 in Guam.
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 43328 covers
A surgeon approaches the esophagus through the chest and uses the upper stomach to create a wrap around the lower esophagus, reinforcing the barrier to reflux. This operation may be performed for gastroesophageal reflux requiring surgical treatment. It is generally done in a hospital operating room by a thoracic or foregut surgeon; the operative report should establish the thoracic route and describe the completed wrap.
Select this code for the thoracic approach, rather than the laparoscopic fundoplasty code when the operation is performed laparoscopically. Documentation should identify the indication, operative approach, and fundoplasty performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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% multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. 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.
43328 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,026.75 |
How the 43328 rate is calculated
Each of 43328’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 · 43328
RVUs × geographic indexes × conversion factor
Work19.41
19.41 RVUs× 1.000 GPCI
Practice expense7.48
7.48 RVUs× 1.000 GPCI
Malpractice4.88
4.88 RVUs× 1.000 GPCI
Adjusted RVUs
31.7700
Conversion factor
$33.4009
Medicare rate
$1,061.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43328
43328 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43328
Fundoplasty
| 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 · 43328
Fundoplasty
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
43328 without 51 · national facility
$1,061.15
Fundoplasty
43328-51 · Second procedure: 50%
$530.58
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%).
43328 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43327Fundoplasty
- 43327 identifies laparoscopic fundoplasty. Use 43328 for the thoracic approach.
- 43320Esophageal reconstruction
- Both concern esophagogastric fundoplasty, but 43328 is specific to the thoracic approach. Confirm the operative route before selecting between them.
- 43325Anastomosis revision
- 43325 covers a fundoplasty performed with repair of a paraesophageal hiatal hernia. Distinguish that combined hernia-repair service from thoracic fundoplasty alone.
- 43334Diaphragmatic hernia repair
- 43334 describes transthoracic diaphragmatic hernia repair. Choose based on whether the documented operation is hernia repair or fundoplasty.
43328 billing questions
How does this differ from laparoscopic fundoplasty code 43327?
Use 43328 when the fundoplasty is performed through a thoracic approach. Code 43327 identifies the laparoscopic approach.
What operative documentation supports 43328?
The report should identify the thoracic route and describe the fundoplasty, including use of the stomach’s upper portion to form a wrap around the distal esophagus.
Is a paraesophageal hernia repair reported with this code?
Determine code selection from the operation performed and the applicable hernia-repair descriptor. Codes 43325 and 43334 address paraesophageal or diaphragmatic hernia repair circumstances and should be distinguished from a fundoplasty alone.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, while other procedures in the same session are subject to the standard multiple-procedure reduction.
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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