Billing code 43285: Device removalMedicare rate & RVUs in Nebraska
Reports laparoscopic removal of an implanted esophageal sphincter augmentation device, such as a magnetic ring, when removal is the operative service.
CMS doesn’t publish an office rate for 43285 in Nebraska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 43285 covers
This code describes laparoscopic removal of an implanted device that augments the lower esophageal sphincter, commonly a magnetic ring placed around the gastroesophageal junction for reflux control. A foregut or general surgeon typically performs the operation in a hospital or other surgical facility. Removal may be needed for persistent swallowing difficulty, device erosion, or another device-related problem. The operative report should identify the implanted device and document its dissection and removal.
Report this code for the removal procedure, not for initial device placement; code 43284 represents laparoscopic augmentation device placement. Document the approach and any other procedures performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
43285 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $570.64 |
How the 43285 rate is calculated
Each of 43285’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43285
RVUs × geographic indexes × conversion factor
Work10.21
10.21 RVUs× 1.000 GPCI
Practice expense6.33
6.33 RVUs× 1.000 GPCI
Malpractice2.73
2.73 RVUs× 1.000 GPCI
Adjusted RVUs
19.2700
Conversion factor
$33.4009
Medicare rate
$643.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43285
43285 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43285
Device removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43285
Device removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43285 without 51 · national facility
$643.64
Device removal
43285-51 · Second procedure: 50%
$321.82
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43285 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43284Sphincter augmentation
- 43284 reports laparoscopic placement of the augmentation device; 43285 reports its laparoscopic removal.
- 43280Fundoplasty
- 43280 reports laparoscopic fundoplasty, an antireflux operation rather than removal of an implanted sphincter device.
- 43281Hernia repair
- 43281 reports laparoscopic repair of a paraesophageal hernia. It does not represent removal of the sphincter augmentation device.
43285 billing questions
How does this differ from code 43284?
Use 43285 for laparoscopic removal of an existing esophageal sphincter augmentation device. Code 43284 is for placing the device.
Can removal and fundoplasty be reported together?
The removal code represents device removal, not a fundoplasty. If the surgeon also performs fundoplasty, document that separate work; multiple-procedure payment rules apply when procedures are performed in the same session.
What documentation supports reporting this code?
The operative report should establish laparoscopic access, identify the esophageal sphincter augmentation device, and describe its dissection and removal.
Does the code include postoperative visits?
It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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