No office rate
Choose 43281 for laparoscopic paraesophageal hernia repair without mesh. Choose 43282 when mesh is implanted as part of the repair.
On this page
CMS RVU26D · Effective 2026-10-01
43282 Hernia repair Medicare reimbursement rates in Vermont
Reports laparoscopic repair of a paraesophageal hernia when mesh is implanted to reinforce the repair, with fundoplasty included when performed. Compare 43282 office and facility rates across CMS payment localities in Vermont.
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 43282 in Vermont?
Vermont 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
$1471.21
1 of 1 localities have a supported rate.
Payment area: Vermont
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 surgery
About 43282: Laparoscopic paraesophageal hernia repair with mesh
Reports laparoscopic repair of a paraesophageal hernia when mesh is implanted to reinforce the repair, with fundoplasty included when performed.
A surgeon uses a laparoscope to reduce the herniated stomach and repair the opening in the diaphragm, implanting mesh to reinforce the repair. The operation is commonly performed in a hospital operating room for a paraesophageal hernia; a fundoplasty may also be performed as part of the operation. The code distinguishes a repair with mesh from the corresponding repair without mesh.
Report the service when the operative record supports laparoscopic paraesophageal hernia repair and documents mesh implantation. Fundoplasty performed as part of the repair is included. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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.
CMS billing rules for 43282
- 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 RVU29.35 · 61%
- Practice expense (office) RVU10.91 · 23%
- Malpractice RVU7.70 · 16%
11.8K
Medicare services in 2024 · #1387 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.
43282 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
43280 describes laparoscopic fundoplasty for an antireflux operation. It is not the paraesophageal hernia repair code.
No office rate
43283 describes laparoscopic esophageal lengthening, such as a Collis procedure. It does not substitute for the paraesophageal hernia repair code.
Compare 43282 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
Vermont →
Office / nonfacility
Unavailable
Facility
$1471.21
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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 43282 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,206
- Code
- 43282
- Physician work
- 29.35
- Practice expense
- 10.91
- Malpractice
- 7.70
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.35 | × 1.000 | 29.3500 |
| Practice expense | 10.91 | × 0.990 | 10.8009 |
| Malpractice | 7.70 | × 0.506 | 3.8962 |
| Total RVUs | 44.0471 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1471.21
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.35 | 1 |
| Practice expense | 10.91 | 0.99 |
| Malpractice | 7.7 | 0.506 |
(29.35 × 1 + 10.91 × 0.99 + 7.7 × 0.506) × $33.4009 = $1471.21
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.
43282 billing questions
How does 43282 differ from 43281?
Both report laparoscopic paraesophageal hernia repair, but 43282 is for a repair with implanted mesh. Use 43281 for the corresponding repair without mesh.
Can fundoplasty be billed separately with 43282?
Fundoplasty performed as part of the paraesophageal hernia repair is included in 43282. The operative report should describe the repair and any fundoplasty performed.
What documentation supports reporting the mesh version?
The operative report should establish the laparoscopic paraesophageal hernia repair and document that mesh was implanted to reinforce the repair.
What is included in the Medicare global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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.
5,20343279,,Lap myotomy heller,A,,21.55,8.79,NA,8.79,,5.58,35.92,35.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20443280,,Laparoscopy fundoplasty,A,,17.65,8.05,NA,8.05,,4.60,30.30,30.30,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20543281,,Lap paraesophag hern repair,A,,25.94,9.97,NA,9.97,,6.75,42.66,42.66,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20643282,,Lap paraesoph her rpr w/mesh,A,,29.35,10.91,NA,10.91,,7.70,47.96,47.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20743283,,Lap esoph lengthening,A,,2.88,0.64,NA,0.64,,0.73,4.25,4.25,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20843284,,Laps esophgl sphnctr agmntj,A,,9.88,6.25,NA,6.25,,2.63,18.76,18.76,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20943285,,Rmvl esophgl sphnctr dev,A,,10.21,6.33,NA,6.33,,2.73,19.27,19.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817