No office rate
43846 identifies a short-limb Roux-en-Y configuration. Choose 43847 when the documented gastric bypass includes small-intestine reconstruction intended to limit absorption.
On this page
CMS RVU26D · Effective 2026-10-01
43847 Bariatric surgery Medicare reimbursement rates in Michigan
Reports bariatric gastric bypass that combines a restrictive stomach procedure with small-intestine reconstruction intended to limit nutrient absorption. Compare 43847 office and facility rates across CMS payment localities in Michigan.
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 43847 in Michigan?
Michigan 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
$1684.00–$1853.76
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.
Bariatric surgery
About 43847: Gastric bypass with intestinal reconstruction
Reports bariatric gastric bypass that combines a restrictive stomach procedure with small-intestine reconstruction intended to limit nutrient absorption.
This code describes a bariatric operation that creates a smaller stomach pouch and reroutes the small intestine so the altered path limits absorption as well as food intake. A bariatric surgeon typically performs it in a hospital operating room for a patient undergoing surgical treatment of obesity. The operative report should show both the gastric restrictive work and the intestinal reconstruction; a gastric bypass without that absorption-limiting reconstruction is a different service.
Report the code for the operation actually performed, using the operative details to distinguish it from other gastric bypass configurations and from procedures that do not include bypass. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43847
- 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 RVU29.52 · 58%
- Practice expense (office) RVU13.12 · 26%
- Malpractice RVU7.90 · 16%
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.
43847 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
43845 describes a duodenal-switch approach with its own gastric and intestinal reconstruction. It is not interchangeable with the bypass configuration reported by 43847.
43842
No office rateGstr rstcv px v-banded gstp
43842 is for vertical-banded gastroplasty, a restrictive operation without the gastric bypass and intestinal reconstruction of 43847.
No office rate
43843 covers another restrictive gastric procedure without gastric bypass. Report 43847 when the operative report supports the bypass and absorption-limiting intestinal reconstruction.
Compare 43847 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
Detroit →
Office / nonfacility
Unavailable
Facility
$1853.76
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1684.00
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43847 billing questions
How does this differ from 43846?
Use 43847 when the gastric bypass includes small-intestine reconstruction intended to limit absorption. Code 43846 describes the short-limb Roux-en-Y configuration.
What operative details support reporting 43847?
The operative report should document the restrictive stomach procedure and the intestinal reconstruction, including the altered intestinal route. Those details distinguish this service from a bypass without absorption-limiting reconstruction.
Are related postoperative visits included?
Yes. The 90-day major-surgery global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other procedures performed in the same session handled?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction. The operative record should support each separately reported procedure.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, while 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.
5,30743843,,Gstr rstcv oth/thn v-band,A,,20.68,9.91,NA,9.91,,5.53,36.12,36.12,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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