Billing code 43325: Anastomosis revisionMedicare rate & RVUs in Texas
Report this code when a surgeon revises an existing esophagus-to-stomach connection through an abdominal approach, commonly to address an anastomotic stricture.
CMS doesn’t publish an office rate for 43325 in Texas.
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 43325 covers
This operation revises an existing connection between the esophagus and stomach through an abdominal approach. A surgeon may perform it when a prior reconstruction has left a narrowed or otherwise problematic anastomosis. Repair of a hiatal hernia may be part of the operation. The service is typically performed in an operating room, often in a hospital setting, by a surgeon managing the patient’s esophageal reconstruction.
Select the code when the operative report supports revision of the prior connection and an abdominal approach; distinguish it from creating a new connection or performing an antireflux procedure. Document the indication, prior anastomosis, approach, and work performed. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this single junction. An assistant at surgery may be paid; co-surgeon payment requires 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.
Where 43325 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,271.67 |
| Beaumont | Unavailable | $1,228.34 |
| Brazoria | Unavailable | $1,232.46 |
| Dallas | Unavailable | $1,250.24 |
| Fort Worth | Unavailable | $1,249.40 |
| Galveston | Unavailable | $1,242.58 |
| Houston | Unavailable | $1,350.39 |
| Rest Of Texas | Unavailable | $1,236.48 |
How the 43325 rate is calculated
Each of 43325’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 · 43325
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 22.04Practice expense 10.18Malpractice 5.89
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43325
43325 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43325
Anastomosis revision
| 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 · 43325
Anastomosis revision
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
43325 without 51 · national facility
$1,272.91
Anastomosis revision
43325-51 · Second procedure: 50%
$636.46
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%).
43325 compared with similar codes
Compare codes
43325 vs 43320 vs 43327: national Medicare rates
Swap in your local Medicare rate.
How to choose
43325 billing questions
How is 43325 distinguished from 43326?
43325 is for revision through an abdominal approach; 43326 is the thoracic-approach counterpart. The operative report should identify the approach used.
Can a hiatal hernia repair be included?
Yes. Hiatal hernia repair may be performed as part of the anastomosis revision; document the work in the operative report.
Is this code for creating a new esophagus-to-stomach connection?
No. It describes revision of an existing connection. A procedure that creates the connection is distinct and should be selected based on the work performed.
What does the 90-day global period include?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
Should modifier 50 be reported?
No. This revision involves a single esophagogastric junction, so modifier 50 is inappropriate.
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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