CPT code 43840: Ulcer repair2026 Medicare rate & RVUs in Nebraska
Reports operative suture repair of a perforated gastric or duodenal ulcer, wound, or injury when the surgeon closes the defect directly.
CMS doesn’t publish an office rate for 43840 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 43840 covers
A surgeon uses this service to close a perforation in the stomach or duodenum caused by an ulcer, wound, or injury. It is typically performed by a general or acute care surgeon in a hospital operating room, often for an urgent abdominal presentation. The operative report should identify the affected organ, the cause and location of the defect, and the suture repair performed. This code describes direct repair, not a bypass or anastomosis created to reconstruct the upper gastrointestinal tract.
Report the code when the operative work is suture closure of the qualifying defect. CMS assigns 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%. Bilateral adjustment is not made; modifier 50 is inappropriate. An assistant at surgery may be paid. 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.
43840 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,127.53 |
How the 43840 rate is calculated
Each of 43840’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 · 43840
RVUs × geographic indexes × conversion factor
Work22.26
22.26 RVUs× 1.000 GPCI
Practice expense10.11
10.11 RVUs× 1.000 GPCI
Malpractice5.73
5.73 RVUs× 1.000 GPCI
Adjusted RVUs
38.1000
Conversion factor
$33.4009
Medicare rate
$1,272.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43840
43840 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43840
Ulcer repair
| 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 · 43840
Ulcer repair
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
43840 without 51 · national facility
$1,272.57
Ulcer repair
43840-51 · Second procedure: 50%
$636.29
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%).
43840 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43800Pyloroplasty
- Pyloroplasty enlarges the pyloric outlet; this code is for suture repair of a perforated gastric or duodenal ulcer, wound, or injury.
- 43810Gastroduodenostomy
- Gastroduodenostomy creates a connection between the stomach and duodenum. Use this code for direct suture closure of a qualifying perforation.
- 43820Gastrojejunostomy
- Gastrojejunostomy creates a connection between the stomach and jejunum. It is not the code for direct suture repair of a perforation.
- 43860Anastomosis revision
- This code revises a gastrojejunal anastomosis without vagotomy; it does not describe primary suture closure of a gastric or duodenal perforation.
43840 billing questions
When should I report this instead of a gastrojejunostomy?
Report this code for direct suture closure of a gastric or duodenal perforation. A gastrojejunostomy describes creation of a connection between the stomach and jejunum, not direct closure.
What operative documentation supports this code?
The report should identify the stomach or duodenum, describe the ulcer, wound, or injury and its perforation, and document the suture repair.
Does the code have a postoperative global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used?
No. CMS does not apply a bilateral adjustment to this code, and modifier 50 is inappropriate.
How are other same-session procedures paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
Can this be billed as team surgery?
No. CMS does not permit team surgery for this code.
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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