No office rate
Both describe open gastrostomy services, but this code is specifically for a neonate; 43830 lacks that neonatal designation.
On this page
CMS RVU26D · Effective 2026-10-01
43831 Gastrostomy Medicare reimbursement rates in Wyoming
Reports open surgical creation of gastric access in a neonate when enteral access is needed and the procedure is performed through an abdominal incision. Compare 43831 office and facility rates across CMS payment localities in Wyoming.
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 43831 in Wyoming?
Wyoming 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
$579.77
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Gastrointestinal surgery
About 43831: Neonatal open gastrostomy
Reports open surgical creation of gastric access in a neonate when enteral access is needed and the procedure is performed through an abdominal incision.
A surgeon creates gastric access through an open abdominal operation in a neonate. The procedure may be chosen when an infant cannot take adequate nutrition by mouth and needs enteral access. Pediatric or general surgeons typically perform it in an operating room, often in an inpatient setting. The operative report should support the neonatal patient population, open approach, and creation of the gastrostomy.
Select this code for the neonatal open procedure rather than an endoscopic or image-guided placement. Document the operative method and any details that distinguish it from other open gastrostomy services. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate.
CMS billing rules for 43831
- 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 RVU8.28 · 46%
- Practice expense (office) RVU7.45 · 42%
- Malpractice RVU2.20 · 12%
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.
43831 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Code 43832 describes open gastrostomy with construction of a gastric tube. Use this code for the neonatal open service when that is the documented procedure.
No office rate
Code 43246 is for endoscopic gastrostomy placement. This code describes an open operation in a neonate.
$784.53
Code 49440 describes image-guided percutaneous gastrostomy placement; this code is for open neonatal surgery.
Compare 43831 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$579.77
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 43831 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,303
- Code
- 43831
- Physician work
- 8.28
- Practice expense
- 7.45
- Malpractice
- 2.20
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.28 | × 1.000 | 8.2800 |
| Practice expense | 7.45 | × 1.000 | 7.4500 |
| Malpractice | 2.20 | × 0.740 | 1.6280 |
| Total RVUs | 17.3580 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$579.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.28 | 1 |
| Practice expense | 7.45 | 1 |
| Malpractice | 2.2 | 0.74 |
(8.28 × 1 + 7.45 × 1 + 2.2 × 0.74) × $33.4009 = $579.77
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.
43831 billing questions
How does this differ from code 43830?
This code identifies an open gastrostomy in a neonate. Code 43830 is the open gastrostomy code without that neonatal designation.
How does this differ from code 43832?
Code 43832 describes an open gastrostomy involving construction of a gastric tube. Choose based on the documented procedure, including the neonatal designation for this code.
Can modifier 50 be used?
No. The CMS bilateral adjustment does not apply to this procedure, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What supports reporting an assistant or co-surgeon?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while 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.
5,30043820,,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
5,30543840,,Gstrrphy sutr duol/gstr ulcr,A,,22.26,10.11,NA,10.11,,5.73,38.10,38.10,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,30643842,,Gstr rstcv px v-banded gstp,N,+,20.50,7.80,NA,7.80,,2.19,30.49,30.49,9,090,0.09,0.81,0.10,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,