Billing code 43870: Gastrostomy closureMedicare rate & RVUs in Oklahoma
Reports surgical closure of a gastrostomy opening and tract, commonly when a feeding tube is no longer needed and the site remains patent.
CMS doesn’t publish an office rate for 43870 in Oklahoma.
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 43870 covers
A surgeon closes the gastric opening and gastrostomy tract when enteral access is no longer needed and the site does not seal after tube removal. The service is typically performed in an operating room, including for a persistent gastrocutaneous opening after a feeding gastrostomy has been discontinued. This is definitive surgical closure, not routine removal or exchange of a tube.
Report the procedure when the operative record supports surgical closure of the gastrostomy, rather than continued access or tube maintenance. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. 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 multiple-procedure reduction. 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.
43870 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $630.92 |
How the 43870 rate is calculated
Each of 43870’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 · 43870
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.15Practice expense 6.30Malpractice 2.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43870
43870 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43870
Gastrostomy closure
| 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 · 43870
Gastrostomy closure
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
43870 without 51 · national facility
$673.70
Gastrostomy closure
43870-51 · Second procedure: 50%
$336.85
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%).
43870 compared with similar codes
Compare codes
43870 vs 43762 vs 43830 vs 43832 vs 43880: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43762G-tube replacement
- 43762 describes percutaneous tube replacement without imaging or endoscopic guidance. Choose 43870 when the service surgically closes the gastrostomy rather than maintaining access.
- 43830Gastrostomy
- 43830 creates an open gastrostomy without construction of a gastric tube; 43870 closes an existing gastrostomy.
- 43832Open gastrostomy
- 43832 creates an open gastrostomy with construction of a gastric tube. It establishes access, unlike 43870, which closes the opening.
- 43880Fistula closure
- 43880 closes a gastrocolic fistula. Use 43870 for surgical closure of a gastrostomy, not a fistula between the stomach and colon.
43870 billing questions
When is this code appropriate instead of a gastrostomy tube replacement code?
Use 43870 for definitive surgical closure of the gastrostomy opening and tract. Tube replacement codes apply when enteral access is being maintained and the tube is exchanged.
Does this code include routine tube removal?
No. The service is surgical closure of the gastrostomy, not simply taking out a tube; the operative documentation should support closure of the opening and tract.
How does the global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Unrelated services are not described by this global-period rule.
Can modifier 50 be used for closure of two gastrostomies?
No. CMS identifies bilateral adjustment as inappropriate for this code. Modifier 50 should not be used.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, while other procedures in the session are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
What documentation supports co-surgeon billing?
CMS requires supporting documentation for co-surgeons. The record should substantiate the co-surgeons' participation in the surgical service.
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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