Billing code 43502: Gastric repairMedicare rate & RVUs in Oregon
Reports gastrotomy with suture repair of a perforated gastric ulcer, typically during operative treatment of an acute stomach perforation.
CMS doesn’t publish an office rate for 43502 in Oregon.
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 43502 covers
This operation opens the stomach to reach and suture a perforated gastric ulcer. A surgeon typically performs it in a hospital operating room when operative management is needed for a gastric ulcer perforation. The operative report should identify the perforation and describe the gastrotomy and repair, distinguishing this service from repair of a bleeding ulcer or a gastrotomy performed for another purpose.
Report the code for the perforated-ulcer repair, not simply for opening or exploring the stomach. The gastrotomy used to access and repair the ulcer is part of the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Do not append modifier 50; the stomach is not a bilateral site. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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.
Where 43502 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,419.70 |
| Rest Of Oregon | Unavailable | $1,355.39 |
How the 43502 rate is calculated
Each of 43502’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 · 43502
RVUs × geographic indexes × conversion factor
Work25.05
25.05 RVUs× 1.000 GPCI
Practice expense10.87
10.87 RVUs× 1.000 GPCI
Malpractice6.69
6.69 RVUs× 1.000 GPCI
Adjusted RVUs
42.6100
Conversion factor
$33.4009
Medicare rate
$1,423.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43502
43502 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43502
Gastric 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 · 43502
Gastric 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
43502 without 51 · national facility
$1,423.21
Gastric repair
43502-51 · Second procedure: 50%
$711.61
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%).
43502 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43501Gastric repair
- Choose 43501 for suture repair of a bleeding gastric ulcer. Choose 43502 for a perforated gastric ulcer.
- 43500Gastrotomy
- 43500 describes gastrotomy for exploration or drainage; 43502 includes suture repair of a perforated gastric ulcer.
- 43510Gastrotomy
- 43510 is a gastrotomy for insertion of a tube, such as a feeding tube, rather than repair of a perforated ulcer.
- 43840Ulcer repair
- 43840 describes gastrorrhaphy for a perforated gastric ulcer, wound, or injury. Distinguish it from 43502 by the documented procedure and whether gastrotomy is performed.
43502 billing questions
How does this differ from 43501?
43502 is for gastrotomy with suture repair of a perforated gastric ulcer. 43501 is for suture repair of a bleeding gastric ulcer.
Can 43500 be reported separately for the gastrotomy?
The gastrotomy is the access used for the repair described by 43502. Do not separately report 43500 for that same opening.
What documentation supports 43502?
The operative report should identify a perforated gastric ulcer and describe the gastrotomy and suture repair. Documentation should distinguish the case from repair of a bleeding ulcer.
Can modifier 50 be used?
No. Modifier 50 is inappropriate for this stomach procedure.
How does the global period affect postoperative care?
The 90-day global period 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 available. Co-surgeon payment requires supporting documentation; team-surgery payment 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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