CPT code 43280: Fundoplasty2026 Medicare rate & RVUs in Nevada
A surgeon creates an antireflux wrap around the distal esophagus laparoscopically, typically for gastroesophageal reflux requiring operative treatment.
CMS doesn’t publish an office rate for 43280 in Nevada.
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 43280 covers
A surgeon uses laparoscopic access to wrap part of the stomach’s fundus around the lower esophagus, strengthening the barrier against reflux. Nissen and Toupet operations are examples of this approach. Foregut or general surgeons typically perform it in a hospital operating room for patients with gastroesophageal reflux requiring surgical treatment, sometimes in the setting of a hiatal defect that does not call for paraesophageal hernia repair coding.
Report the service when the operative documentation supports a laparoscopic fundoplasty as the principal procedure; include the indication and the technique performed. If the operation repairs a paraesophageal hernia, 43281 or 43282 may be the applicable code because fundoplasty is included when performed. 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 other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons require 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.
43280 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $986.66 |
How the 43280 rate is calculated
Each of 43280’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 · 43280
RVUs × geographic indexes × conversion factor
Work17.65
17.65 RVUs× 1.000 GPCI
Practice expense8.05
8.05 RVUs× 1.000 GPCI
Malpractice4.60
4.60 RVUs× 1.000 GPCI
Adjusted RVUs
30.3000
Conversion factor
$33.4009
Medicare rate
$1,012.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43280
43280 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43280
Fundoplasty
| 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 · 43280
Fundoplasty
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
43280 without 51 · national facility
$1,012.05
Fundoplasty
43280-51 · Second procedure: 50%
$506.03
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%).
43280 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43281Hernia repair
- Choose 43281 for laparoscopic paraesophageal hernia repair without mesh; its reported work includes fundoplasty when performed. Use 43280 for fundoplasty without that hernia repair.
- 43282Hernia repair
- Choose 43282 for laparoscopic paraesophageal hernia repair with mesh; fundoplasty is included when performed. It is not a separate fundoplasty-only service.
- 43279Heller myotomy
- 43279 treats achalasia with laparoscopic esophagomyotomy and includes fundoplasty when performed. 43280 describes the fundoplasty operation without that myotomy.
43280 billing questions
When should 43280 be chosen instead of 43281 or 43282?
Use 43280 for a laparoscopic fundoplasty without a separately coded paraesophageal hernia repair. Codes 43281 and 43282 describe paraesophageal hernia repair and include fundoplasty when performed; 43282 applies when mesh is used.
Can 43280 be reported with a paraesophageal hernia repair code?
Fundoplasty is included in 43281 and 43282 when performed, so do not separately report 43280 for that work.
What documentation supports 43280?
The operative report should establish laparoscopic access, the fundoplasty technique, and the clinical indication. It should also clarify whether the operation included paraesophageal hernia repair.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. This applies to care related to the fundoplasty.
How are other procedures in the same session affected?
The highest-valued procedure is paid in full, while other procedures performed in the same session are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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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