No office rate
Choose 43631 when the distal gastric remnant is connected to the duodenum rather than reconstructed with a Roux-en-Y jejunal limb.
On this page
CMS RVU26D · Effective 2026-10-01
43633 Partial gastrectomy Medicare reimbursement rates in Maine
Reports removal of the distal stomach with Roux-en-Y reconstruction, when the operative plan reconnects the remaining stomach to a jejunal limb. Compare 43633 office and facility rates across CMS payment localities in Maine.
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 43633 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1638.47–$1670.94
2 of 2 localities have a supported rate.
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.
Upper GI surgery
About 43633: Distal partial gastrectomy with Roux-en-Y
Reports removal of the distal stomach with Roux-en-Y reconstruction, when the operative plan reconnects the remaining stomach to a jejunal limb.
The surgeon removes the distal portion of the stomach and restores continuity by connecting the gastric remnant to a Roux limb of the jejunum. This operation may be performed for gastric cancer or other conditions requiring distal stomach resection. It is typically performed by a general or gastrointestinal surgeon in an operating room, often in a hospital setting.
Select this code from the operative report’s resection extent and reconstruction, not diagnosis alone; documentation should identify the portion removed and the Roux-en-Y configuration. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this stomach procedure. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 43633
- 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 RVU32.31 · 61%
- Practice expense (office) RVU12.65 · 24%
- Malpractice RVU8.21 · 15%
657
Medicare services in 2024 · #3321 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.
43633 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
Choose 43632 for a distal resection with direct gastrojejunostomy; this code represents Roux-en-Y reconstruction.
No office rate
43620 represents total stomach removal. This code is for resection of only part of the stomach.
No office rate
43644 describes a laparoscopic Roux-en-Y gastric bypass for a different clinical purpose; it is not the code for distal stomach resection.
Compare 43633 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$1638.47
Southern Maine →
Office / nonfacility
Unavailable
Facility
$1670.94
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43633 billing questions
How does this differ from a direct gastrojejunostomy reconstruction?
Use this code when the distal stomach resection is reconstructed with a Roux-en-Y configuration. A direct gastrojejunostomy reconstruction is represented by 43632.
Does the code include the Roux-en-Y reconstruction?
Yes. The reconstruction is part of the operation described by this code; the operative report should document the gastric resection and Roux-en-Y configuration.
Can modifier 50 be used?
No. The stomach anatomy and procedure do not support bilateral reporting with modifier 50.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,26743622,,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
5,27143634,,Removal of stomach partial,A,,35.72,13.45,NA,13.45,,9.57,58.74,58.74,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27243635,,Removal of stomach partial,A,,2.01,0.48,NA,0.48,,0.53,3.02,3.02,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27343640,,Vagotomy & pylorus repair,A,,19.07,9.42,NA,9.42,,5.09,33.58,33.58,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00