CPT Code 43845

2026 Medicare national rate

Medicare payment = total RVUs × GPCI (locality adjustment) × conversion factor. At the national level (GPCI = 1.0), 54.70 × 33.4009 = $1827.03 (office). Facility rates are lower because the facility separately bills its overhead.

RVU breakdown

PC/TC: Physician service — not subject to a professional/technical split.

Billing notes

• 43845 carries a 90-day global period: related follow-up care within 90 days is bundled into this payment and is not separately billable.
• The national allowable is built from 54.70 total office RVUs × the $33.4009 conversion factor; multiply by your locality GPCIs (above) to reconcile a specific remittance.

Billing & payment rules

Multiple procedures

Standard multiple-procedure reduction applies (100% / 50% / 50%…).

Assistant surgeon

Assistant surgeon may be paid.

Co-surgeons

Co-surgeons payable with supporting documentation.

Team surgeons

Team surgeons not permitted.

Global period

90-day global period — most related follow-up care within 90 days is bundled into this code's payment.

2026 rate by locality

Computed from CMS 2026 GPCIs: (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × $33.4009. Your MAC's locality may differ.

Related Surgery codes

Related guides

• Modifier 25: When to Use It and Common Mistakes
• Medical Billing Modifier Cheat Sheet: The 20 Modifiers You Actually Use