Billing code 43880: Fistula closureMedicare rate & RVUs in Utah
Reports operative closure of an abnormal connection between the stomach and colon, with payment subject to the major-surgery global period and applicable same-session reductions.
CMS doesn’t publish an office rate for 43880 in Utah.
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 43880 covers
billing code 43880 describes surgery to close a gastrocolic fistula, an abnormal passage connecting the stomach and colon. A general or gastrointestinal surgeon typically performs the repair in an operating room. The operative record should identify the connection and document the work done to close it; a gastrostomy opening or a different gastric anastomosis is not this fistula.
Report the code for the fistula closure, supported by the operative findings and procedure details. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same 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 service.
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.
43880 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,450.05 |
How the 43880 rate is calculated
Each of 43880’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 · 43880
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 26.50Practice expense 11.22Malpractice 7.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43880
43880 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43880
Fistula closure
| 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 · 43880
Fistula closure
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
43880 without 51 · national facility
$1,496.69
Fistula closure
43880-51 · Second procedure: 50%
$748.35
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%).
43880 compared with similar codes
Compare codes
43880 vs 43870 vs 43810 vs 43820: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43870Gastrostomy closure
- 43870 addresses closure of a gastrostomy opening. billing code 43880 is for a fistula connecting the stomach and colon.
- 43810Gastroduodenostomy
- 43810 describes a gastroduodenal anastomosis, connecting the stomach and duodenum; it is not closure of a gastrocolic fistula.
- 43820Gastrojejunostomy
- 43820 describes a gastrojejunal anastomosis without vagotomy. Choose 43880 when the documented procedure closes a stomach-to-colon fistula.
43880 billing questions
How is this different from surgical gastrostomy closure, 43870?
43880 closes a connection between the stomach and colon. Use 43870 for surgical closure of a gastrostomy opening.
What documentation supports 43880?
The operative report should identify the gastrocolic fistula and describe the surgical closure performed. Document other distinct procedures separately.
Is the day-before visit included in the global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is 43880 paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Can 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.
Should modifier 50 be appended?
No. The anatomy and service do not support bilateral reporting, 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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