No office rate
Both are total gastrectomy codes, but the reconstruction documented for the operation distinguishes the applicable code. Use 43622 for the Roux-en-Y reconstruction described here.
On this page
CMS RVU26D · Effective 2026-10-01
43622 Total gastrectomy Medicare reimbursement rates in Kansas
Reports complete stomach removal with Roux-en-Y reconstruction, typically for gastric cancer or other disease requiring removal of the entire stomach. Compare 43622 office and facility rates across CMS payment localities in Kansas.
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 43622 in Kansas?
Kansas 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
$1910.29
1 of 1 localities have a supported rate.
Payment area: Kansas
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.
Gastric surgery
About 43622: Total gastrectomy with Roux-en-Y reconstruction
Reports complete stomach removal with Roux-en-Y reconstruction, typically for gastric cancer or other disease requiring removal of the entire stomach.
This service removes the entire stomach and restores digestive continuity by connecting the esophagus to the small intestine in a Roux-en-Y configuration. It is generally performed by a general or surgical oncologist in an operating room, commonly for gastric malignancy when partial removal is not appropriate. The reconstruction is part of the reported operation, not a separate service merely because it requires additional surgical work.
Select this code when the operative report supports complete stomach removal and the specified Roux-en-Y reconstruction; distinguish it from total gastrectomy codes describing other reconstruction approaches and from partial gastrectomy. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for removal of a single stomach. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43622
- 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 RVU39.03 · 61%
- Practice expense (office) RVU14.26 · 22%
- Malpractice RVU10.46 · 16%
32
Medicare services in 2024 · #5622 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.
43622 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
This is a sibling total gastrectomy code for a different coded approach. Base the choice on the reconstruction actually performed and documented.
No office rate
This is a partial gastrectomy code. Choose it when the operation removes only part of the stomach rather than the entire organ.
No office rate
This represents excision of a gastric lesion, not total stomach removal with Roux-en-Y reconstruction.
Compare 43622 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1910.29
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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 43622 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,267
- Code
- 43622
- Physician work
- 39.03
- Practice expense
- 14.26
- Malpractice
- 10.46
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 39.03 | × 1.000 | 39.0300 |
| Practice expense | 14.26 | × 0.904 | 12.8910 |
| Malpractice | 10.46 | × 0.504 | 5.2718 |
| Total RVUs | 57.1929 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1910.29
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 39.03 | 1 |
| Practice expense | 14.26 | 0.904 |
| Malpractice | 10.46 | 0.504 |
(39.03 × 1 + 14.26 × 0.904 + 10.46 × 0.504) × $33.4009 = $1910.29
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.
43622 billing questions
When should this code be chosen instead of a partial gastrectomy code?
Use it when the operation removes the entire stomach and includes Roux-en-Y reconstruction. A resection that leaves part of the stomach is represented by the applicable partial gastrectomy code.
Can the reconstruction be billed separately?
The Roux-en-Y reconstruction is included in this total gastrectomy service. Do not report a separate code solely for the reconstruction that completes the operation.
Should modifier 50 be reported?
No. Modifier 50 is inappropriate because the operation concerns a single stomach, not paired anatomy.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The global period begins around the surgery and covers that related care.
What documentation supports this code?
The operative report should establish removal of the entire stomach and describe the Roux-en-Y reconstruction. It should also distinguish the operation from a partial resection or a total gastrectomy using another reconstruction approach.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
5,26443611,,Excision of stomach lesion,A,,19.87,9.57,NA,9.57,,4.96,34.40,34.40,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26543620,,Removal of stomach,A,,33.19,12.84,NA,12.84,,8.89,54.92,54.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26643621,,Removal of stomach,A,,38.54,14.30,NA,14.30,,9.78,62.62,62.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26743622,,Removal of stomach,A,,39.03,14.26,NA,14.26,,10.46,63.75,63.75,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26843631,,Removal of stomach partial,A,,23.90,10.55,NA,10.55,,6.14,40.59,40.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26943632,,Removal of stomach partial,A,,34.26,13.17,NA,13.17,,8.72,56.15,56.15,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27043633,,Removal of stomach partial,A,,32.31,12.65,NA,12.65,,8.21,53.17,53.17,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958