No office rate
Choose 43825 when the operation includes vagotomy along with the gastrojejunostomy; 43820 describes the gastrojejunostomy without vagotomy.
On this page
CMS RVU26D · Effective 2026-10-01
43825 Gastrojejunostomy Medicare reimbursement rates in Utah
Reports a surgical connection between the stomach and jejunum performed with vagotomy, commonly for gastric drainage when the usual outlet is unsuitable. Compare 43825 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 43825 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
$1191.22
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.
Digestive system surgery
About 43825: Gastrojejunostomy with vagotomy
Reports a surgical connection between the stomach and jejunum performed with vagotomy, commonly for gastric drainage when the usual outlet is unsuitable.
The surgeon creates an anastomosis between the stomach and jejunum and performs a vagotomy, which interrupts vagal nerve input to reduce gastric acid stimulation. This operation may be used when gastric emptying through the pylorus or duodenum is impaired, including selected cases of gastric outlet obstruction. It is performed by a surgeon in an operating room, generally in a hospital setting.
Report this code when both the gastrojejunostomy and vagotomy are part of the operation; the operative report should document the anastomosis and nerve division. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43825
- 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 RVU21.22 · 58%
- Practice expense (office) RVU9.94 · 27%
- Malpractice RVU5.68 · 15%
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.
43825 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
43810 creates a connection from the stomach to the duodenum. This code creates the connection to the jejunum and includes vagotomy.
No office rate
43865 is for revision of a gastrojejunal anastomosis with vagotomy, rather than creation of the gastrojejunostomy described here.
Compare 43825 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
$1191.22
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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 43825 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,301
- Code
- 43825
- Physician work
- 21.22
- Practice expense
- 9.94
- Malpractice
- 5.68
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.22 | × 1.000 | 21.2200 |
| Practice expense | 9.94 | × 0.940 | 9.3436 |
| Malpractice | 5.68 | × 0.898 | 5.1006 |
| Total RVUs | 35.6642 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$1191.22
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.22 | 1 |
| Practice expense | 9.94 | 0.94 |
| Malpractice | 5.68 | 0.898 |
(21.22 × 1 + 9.94 × 0.94 + 5.68 × 0.898) × $33.4009 = $1191.22
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.
43825 billing questions
How does this differ from 43820?
43825 includes a vagotomy with the gastrojejunostomy. Use 43820 when the gastrojejunostomy is performed without vagotomy.
Can the vagotomy be reported separately?
The vagotomy is included in this combined service. The operative report should support both the gastrojejunostomy and the vagotomy.
Should modifier 50 be added?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting this code?
The operative report should describe the stomach-to-jejunum anastomosis and the vagotomy. It should make clear that both were performed during the operation.
How is this code affected by other procedures performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery 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 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.
5,29843800,,Pyloroplasty,A,,15.04,7.30,NA,7.30,,3.74,26.08,26.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,29943810,,Gastroduodenostomy,A,,16.46,7.76,NA,7.76,,4.40,28.62,28.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30043820,,Gastrojejunostomy wo vagotmy,A,,21.97,10.11,NA,10.11,,5.54,37.62,37.62,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30143825,,Gastrojejunostomy w/vagotomy,A,,21.22,9.94,NA,9.94,,5.68,36.84,36.84,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30243830,,Gstrst open wo constj tube,A,,10.58,6.98,NA,6.98,,2.68,20.24,20.24,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30343831,,Gastrostomy open neonatal,A,,8.28,7.45,NA,7.45,,2.20,17.93,17.93,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30443832,,Gstrst open w/constj tube,A,,16.91,8.23,NA,8.23,,4.38,29.52,29.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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