Billing code 43652: VagotomyMedicare rate & RVUs in Ohio
Reports laparoscopic selective vagotomy, in which the surgeon divides vagal branches supplying the stomach while preserving branches to other abdominal organs.
CMS doesn’t publish an office rate for 43652 in Ohio.
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 43652 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $713.16 |
How the 43652 rate is calculated
Each of 43652’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 · 43652
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.83Practice expense 6.94Malpractice 3.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43652
43652 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43652
Vagotomy
| 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) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43652
Vagotomy
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
43652 without 51 · national facility
$732.48
Vagotomy
43652-51 · Second procedure: 50%
$366.24
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%).
43652 compared with similar codes
Compare codes
43652 vs 43651 vs 43640 vs 43641: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43651Vagal electrode placement
- Both are laparoscopic vagotomy codes. Choose 43652 for selective vagotomy and 43651 for truncal or highly selective vagotomy, following the operative documentation.
- 43640Vagotomy
- 43640 describes open vagotomy with a drainage procedure. It is not the laparoscopic selective vagotomy reported with 43652.
- 43641Vagotomy
- 43641 describes open vagotomy with antrectomy. 43652 identifies a laparoscopic selective vagotomy, not a vagotomy combined with stomach resection.
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 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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