No office rate
Both are laparoscopic vagotomy codes. Choose 43652 for selective vagotomy and 43651 for truncal or highly selective vagotomy, following the operative documentation.
On this page
CMS RVU26D · Effective 2026-10-01
43652 Vagotomy Medicare reimbursement rates in Maine
Reports laparoscopic selective vagotomy, in which the surgeon divides vagal branches supplying the stomach while preserving branches to other abdominal organs. Compare 43652 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 43652 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
$674.04–$691.45
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.
Gastrointestinal surgery
About 43652: Laparoscopic selective vagotomy
Reports laparoscopic selective vagotomy, in which the surgeon divides vagal branches supplying the stomach while preserving branches to other abdominal organs.
A surgeon performs this operation through laparoscopic access, dividing vagal branches directed to the stomach while preserving the hepatic and celiac branches. Selective vagotomy has been used in treating peptic ulcer disease; the operative report should establish the selective nerve division and laparoscopic approach. It is distinct from truncal or highly selective vagotomy, which describes a different pattern of nerve division.
Report 43652 when the documented procedure is a laparoscopic selective vagotomy, rather than a different vagotomy type or an open operation. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 43652
- 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 RVU11.83 · 54%
- Practice expense (office) RVU6.94 · 32%
- Malpractice RVU3.16 · 14%
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.
43652 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
43640 describes open vagotomy with a drainage procedure. It is not the laparoscopic selective vagotomy reported with 43652.
No office rate
43641 describes open vagotomy with antrectomy. 43652 identifies a laparoscopic selective vagotomy, not a vagotomy combined with stomach resection.
Compare 43652 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
$674.04
Southern Maine →
Office / nonfacility
Unavailable
Facility
$691.45
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43652 billing questions
How is 43652 distinguished from 43651?
43652 is for laparoscopic selective vagotomy. Use 43651 for laparoscopic truncal or highly selective vagotomy, as documented in the operative report.
What documentation supports 43652?
The operative report should identify the laparoscopic approach and describe selective division of the gastric vagal branches, distinguishing it from truncal or highly selective division.
Does 43652 have a global period?
Yes. Its 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?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50% when performed in the same session.
Can modifier 50 be reported, and may an assistant or co-surgeon be paid?
Modifier 50 is inappropriate for this code. An assistant at surgery may be paid, while co-surgeon payment requires supporting documentation.
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.
5,27743647,,Lap impl electrode antrum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27843648,,Lap revise/remv eltrd antrum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27943651,,Laparoscopy vagus nerve,A,,9.88,6.47,NA,6.47,,2.63,18.98,18.98,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,28043652,,Laparoscopy vagus nerve,A,,11.83,6.94,NA,6.94,,3.16,21.93,21.93,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,28143653,,Laparoscopy gastrostomy,A,,8.27,6.49,NA,6.49,,2.16,16.92,16.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,28243659,,Unlisted laps px stomach,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,28343752,,Nasal/orogastric w/tube plmt,A,,0.79,0.15,NA,0.15,,0.09,1.03,1.03,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00