No office rate
43327 identifies laparoscopic fundoplasty. Use 43328 for the thoracic approach.
On this page
CMS RVU26D · Effective 2026-10-01
43328 Fundoplasty Medicare reimbursement rates in Iowa
Reports an antireflux fundoplasty performed through a thoracic approach, with the stomach’s upper portion wrapped around the distal esophagus. Compare 43328 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 43328 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$941.62
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Esophageal surgery
About 43328: Thoracic esophagogastric fundoplasty
Reports an antireflux fundoplasty performed through a thoracic approach, with the stomach’s upper portion wrapped around the distal esophagus.
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.
CMS billing rules for 43328
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.41 · 61%
- Practice expense (office) RVU7.48 · 24%
- Malpractice RVU4.88 · 15%
25
Medicare services in 2024 · #5790 by national volume
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 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Both concern esophagogastric fundoplasty, but 43328 is specific to the thoracic approach. Confirm the operative route before selecting between them.
No office rate
43325 covers a fundoplasty performed with repair of a paraesophageal hiatal hernia. Distinguish that combined hernia-repair service from thoracic fundoplasty alone.
No office rate
43334 describes transthoracic diaphragmatic hernia repair. Choose based on whether the documented operation is hernia repair or fundoplasty.
Compare 43328 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$941.62
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43328 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,227
- Code
- 43328
- Physician work
- 19.41
- Practice expense
- 7.48
- Malpractice
- 4.88
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.41 | × 1.000 | 19.4100 |
| Practice expense | 7.48 | × 0.915 | 6.8442 |
| Malpractice | 4.88 | × 0.397 | 1.9374 |
| Total RVUs | 28.1916 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$941.62
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.41 | 1 |
| Practice expense | 7.48 | 0.915 |
| Malpractice | 4.88 | 0.397 |
(19.41 × 1 + 7.48 × 0.915 + 4.88 × 0.397) × $33.4009 = $941.62
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,22443320,,Fuse esophagus & stomach,A,,22.73,10.35,NA,10.35,,6.08,39.16,39.16,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22543325,,Revise esophagus & stomach,A,,22.04,10.18,NA,10.18,,5.89,38.11,38.11,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22643327,,Esoph fundoplasty lap,A,,13.02,7.20,NA,7.20,,3.47,23.69,23.69,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22743328,,Esoph fundoplasty thor,A,,19.41,7.48,NA,7.48,,4.88,31.77,31.77,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22843330,,Esophagomyotomy abdominal,A,,21.64,10.08,NA,10.08,,5.77,37.49,37.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22943331,,Esophagomyotomy thoracic,A,,22.48,10.25,NA,10.25,,5.66,38.39,38.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23043332,,Transab esoph hiat hern rpr,A,,19.13,8.26,NA,8.26,,4.88,32.27,32.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136