No office rate
43846 is a primary open gastric bypass operation with short Roux-en-Y reconstruction. Choose 43848 for revision of an existing restrictive procedure.
On this page
CMS RVU26D · Effective 2026-10-01
43848 Bariatric revision Medicare reimbursement rates in Kentucky
Reports open revision of prior gastric restrictive surgery, including revision of the gastrojejunal anastomosis when part of the bariatric reconstruction. Compare 43848 office and facility rates across CMS payment localities in Kentucky.
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 43848 in Kentucky?
Kentucky 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
$1718.66
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Bariatric surgery
About 43848: Open revision of gastric restrictive procedure
Reports open revision of prior gastric restrictive surgery, including revision of the gastrojejunal anastomosis when part of the bariatric reconstruction.
A bariatric surgeon uses an open approach to revise a prior gastric restrictive operation, such as a gastric bypass. The work may involve changing the existing gastric anatomy or revising its gastrojejunal connection as part of the bariatric revision. These operations are typically performed in a hospital operating room for patients whose existing bariatric anatomy requires surgical revision.
Report this code for revision of the prior restrictive procedure, not for creating a new bypass or revising only an access port. The operative report should identify the prior procedure, the anatomy revised, and the work performed. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the major-surgery global period. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Report one service for the single operative anatomy rather than a bilateral service.
CMS billing rules for 43848
- 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 RVU31.93 · 60%
- Practice expense (office) RVU13.40 · 25%
- Malpractice RVU8.32 · 16%
104
Medicare services in 2024 · #4853 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.
43848 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
43847 describes a primary restrictive procedure with small-intestine reconstruction. It is not the code for revising an existing bariatric operation.
No office rate
43886 is for open revision of the subcutaneous port component. Use 43848 when the surgeon revises the gastric restrictive anatomy.
No office rate
43860 describes gastrojejunal anastomosis revision without vagotomy. 43848 applies when that work is part of revising the prior gastric restrictive procedure.
Compare 43848 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$1718.66
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 43848 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
5,311
- Code
- 43848
- Physician work
- 31.93
- Practice expense
- 13.40
- Malpractice
- 8.32
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.93 | × 1.000 | 31.9300 |
| Practice expense | 13.40 | × 0.889 | 11.9126 |
| Malpractice | 8.32 | × 0.915 | 7.6128 |
| Total RVUs | 51.4554 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1718.66
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 31.93 | 1 |
| Practice expense | 13.4 | 0.889 |
| Malpractice | 8.32 | 0.915 |
(31.93 × 1 + 13.4 × 0.889 + 8.32 × 0.915) × $33.4009 = $1718.66
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.
43848 billing questions
How is this different from 43846?
43846 describes creating a gastric bypass with a short Roux-en-Y reconstruction. Use 43848 when the surgeon revises an existing gastric restrictive procedure.
Can the gastrojejunal anastomosis revision be reported separately?
Revision of the gastrojejunal anastomosis is included when it is part of the gastric restrictive procedure revision reported with 43848. The operative note should make clear whether the anastomotic work is part of that revision.
When should 43886 be considered instead?
Consider 43886 when the operation is limited to revising the subcutaneous port component. Code 43848 describes revision of the gastric restrictive anatomy.
What documentation supports reporting 43848?
Document the prior bariatric procedure, the anatomy revised, the open approach, and the specific reconstructive work performed.
How does the global period affect postoperative services?
Medicare's 90-day 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.
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.
5,30843845,,Gastroplasty duodenal switch,A,,32.47,13.66,NA,13.66,,8.57,54.70,54.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30943846,,Gstr rstcv px shrt roux-en-y,A,,26.72,12.45,NA,12.45,,7.16,46.33,46.33,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,31043847,,Gstr rstcv px sm int rcnstj,A,,29.52,13.12,NA,13.12,,7.90,50.54,50.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,31143848,,Revj open gstr rstcv px,A,,31.93,13.40,NA,13.40,,8.32,53.65,53.65,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,31243860,,Revj gstr/jj anast w/o vgtmy,A,,27.19,11.29,NA,11.29,,6.91,45.39,45.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,31343865,,Revj gstr/jj anast w/vgtmy,A,,28.32,11.66,NA,11.66,,7.57,47.55,47.55,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,31443870,,Closure gastrostomy surgical,A,,11.15,6.30,NA,6.30,,2.72,20.17,20.17,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631