No office rate
Both involve distal partial stomach removal. Choose 43632 for gastrojejunostomy reconstruction and 43631 for gastroduodenostomy reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
43632 Partial gastrectomy Medicare reimbursement rates in Utah
Reports distal partial stomach removal with reconstruction connecting the remaining stomach to the jejunum, commonly performed for gastric disease requiring resection. Compare 43632 office and facility rates across CMS payment localities in Utah.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 43632 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1819.36
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gastric surgery
About 43632: Distal partial gastrectomy with gastrojejunostomy
Reports distal partial stomach removal with reconstruction connecting the remaining stomach to the jejunum, commonly performed for gastric disease requiring resection.
A surgeon removes the distal portion of the stomach and restores continuity by connecting the remaining stomach to the jejunum. The gastrojejunostomy routes food past the duodenum. This operation may be performed for a resectable gastric tumor or other disease requiring removal of the distal stomach, typically in an operating room. The procedure includes the reconstruction specified by this code; it is not simply a stomach lesion excision or a total gastrectomy.
Select this code when the operative report supports distal partial resection and gastrojejunostomy reconstruction. Document the resection and the reconstruction performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this single-stomach operation.
CMS billing rules for 43632
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU34.26 · 61%
- Practice expense (office) RVU13.17 · 23%
- Malpractice RVU8.72 · 16%
818
Medicare services in 2024 · #3125 by national volume
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.
43632 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
Both involve distal partial stomach removal, but 43633 specifies Roux-en-Y reconstruction rather than the gastrojejunostomy configuration reported with 43632.
No office rate
43620 is for total gastrectomy; 43632 describes removal of only the distal portion of the stomach with gastrojejunostomy reconstruction.
Compare 43632 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Utah →
Office / nonfacility
Unavailable
Facility
$1819.36
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43632 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,269
- Code
- 43632
- Physician work
- 34.26
- Practice expense
- 13.17
- Malpractice
- 8.72
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 34.26 | × 1.000 | 34.2600 |
| Practice expense | 13.17 | × 0.940 | 12.3798 |
| Malpractice | 8.72 | × 0.898 | 7.8306 |
| Total RVUs | 54.4704 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$1819.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 34.26 | 1 |
| Practice expense | 13.17 | 0.94 |
| Malpractice | 8.72 | 0.898 |
(34.26 × 1 + 13.17 × 0.94 + 8.72 × 0.898) × $33.4009 = $1819.36
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
43632 billing questions
How does this differ from 43631?
Both describe distal partial gastrectomy, but 43632 includes gastrojejunostomy reconstruction. Choose 43631 when the reconstruction is gastroduodenostomy.
Is the gastrojejunostomy separately reported?
The gastrojejunostomy reconstruction is part of this procedure. The operative report should establish that the remaining stomach was connected to the jejunum.
When should 43633 be considered instead?
Use 43633 when the documented distal partial gastrectomy uses Roux-en-Y reconstruction rather than the gastrojejunostomy configuration described by 43632.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be reported?
CMS allows payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,26643621,,Removal of stomach,A,,38.54,14.30,NA,14.30,,9.78,62.62,62.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26743622,,Removal of stomach,A,,39.03,14.26,NA,14.26,,10.46,63.75,63.75,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26843631,,Removal of stomach partial,A,,23.90,10.55,NA,10.55,,6.14,40.59,40.59,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,26943632,,Removal of stomach partial,A,,34.26,13.17,NA,13.17,,8.72,56.15,56.15,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27043633,,Removal of stomach partial,A,,32.31,12.65,NA,12.65,,8.21,53.17,53.17,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27143634,,Removal of stomach partial,A,,35.72,13.45,NA,13.45,,9.57,58.74,58.74,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,27243635,,Removal of stomach partial,A,,2.01,0.48,NA,0.48,,0.53,3.02,3.02,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985