Billing code 43635: Partial gastrectomyMedicare rate & RVUs in Oregon
This add-on reports partial removal of the stomach when performed with a qualifying primary procedure during the same operative service.
CMS doesn’t publish an office rate for 43635 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 43635 covers
billing code 43635 represents partial removal of stomach tissue as an additional operative service accompanying a primary procedure. A surgeon may perform partial stomach resection during an operation when the documented surgical plan requires removal of only part of the stomach. The code identifies the resection service; the primary procedure and the operative details establish the broader surgical context.
Report 43635 only with a primary procedure that permits this add-on, and document the portion of stomach removed and how the work relates to the primary operation. It is not a stand-alone code. CMS treats payment for the add-on as part of the primary procedure’s global period, so the add-on is paid within that period. The primary code should reflect the operation performed; codes 43631–43634 distinguish partial gastrectomy procedures by location and reconstruction.
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 43635 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $99.19 |
| Rest Of Oregon | Unavailable | $95.55 |
How the 43635 rate is calculated
Each of 43635’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 · 43635
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.01Practice expense 0.48Malpractice 0.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43635
The CMS indicators that decide how 43635 is paid alongside other services.
CMS payment indicators · 43635
Partial gastrectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
43635 without 80 · national facility
$100.87
Partial gastrectomy
43635-80 · Assistant: 16%
$16.14
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
43635 compared with similar codes
Compare codes
43635 vs 43631 vs 43633 vs 43610 vs 43620: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43631Partial gastrectomy
- 43631 describes a primary distal partial gastrectomy with gastroduodenostomy. Code 43635 is an add-on and should not replace the primary code.
- 43633Partial gastrectomy
- 43633 describes a primary distal partial gastrectomy with Roux-en-Y reconstruction. Select the primary code from the documented operation and use 43635 only as an eligible add-on.
- 43610Gastric lesion excision
- 43610 describes excision of a stomach lesion. Use the code that matches the documented service; 43635 represents partial stomach removal as an add-on.
- 43620Total gastrectomy
- 43620 represents total rather than partial stomach removal. The operative report should establish whether the stomach was removed in part or in its entirety.
43635 billing questions
Can 43635 be reported by itself?
No. It is an add-on code and must be reported with a qualifying primary procedure.
How is 43635 different from 43631–43634?
Codes 43631–43634 describe primary partial gastrectomy procedures, with distinctions based on location and reconstruction. Code 43635 is an add-on, not a substitute for those primary procedure codes.
What documentation supports reporting 43635?
The operative report should identify the partial stomach resection performed and explain its relationship to the primary operation.
How does the global period affect payment?
CMS pays 43635 within the global period of the primary procedure. Report it only with that primary procedure.
Should 43635 replace a code for excision of a stomach lesion?
Not based on the short descriptor alone. Distinguish partial stomach resection from lesion excision using the documented extent and nature of the operation.
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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