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    OpenPayerBilling CodesRepair Procedures on the EsophagusCPT cpt-43332-paraesophageal-hiatal-hernia-repair-with-fundoplication
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    CPT 43332: Paraesophageal Hiatal Hernia Repair with Fundoplication

    Medicare pays $1085 on average nationally for this procedure.

    CPT code 43332 describes open repair of a paraesophageal hiatal hernia via an abdominal incision with fundoplication performed and no mesh or prosthetic implantation; the service is a surgical procedure typically performed in an inpatient or outpatient hospital operating room for adult patients (not appropriate for a newborn).

    For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult (often middle-aged to elderly) presenting with symptomatic paraesophageal hiatal hernia causing reflux, dysphagia, chest or upper abdominal pain, or recurrent aspiration. After gastroenterology evaluation including upper endoscopy and imaging (barium swallow, CT), and failure of optimized medical therapy for gastroesophageal reflux disease (GERD) or symptom progression, the surgeon schedules an open abdominal repair with fundoplication via an abdominal incision using CPT 43332. Preoperative workflow includes pre-op assessment, anesthesia evaluation, informed consent discussing risks and benefits of open repair without prosthetic mesh, baseline labs, and imaging review. Intraoperative workflow involves abdominal access, reduction of the herniated stomach, crural repair, and performance of a fundoplication (typically Nissen or partial depending on anatomy). No mesh or prosthetic is implanted. Postoperative care includes recovery in PACU, pain control, advancement of diet from clear liquids, and discharge planning with activity restrictions and outpatient follow-up for wound check and swallow function as indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    43280Esophagoscopy, flexible, transoral; diagnostic, with or without collection of specimen(s) by brushing or washingPreoperative diagnostic evaluation for esophageal mucosa, reflux assessment
    43235Esophagogastroduodenoscopy, flexible, diagnosticCommon preoperative diagnostic procedure to assess esophagitis, Barrett mucosa, or hiatal hernia
    49002Exploratory laparotomy, with or without biopsy(s) (separate procedure)May be performed if exploratory abdominal approach is required prior to definitive hiatal repair
    43283Esophagoscopy, flexible, with biopsyUsed when mucosal biopsies are performed during preoperative endoscopy
    43760Laparoscopy, surgical, repair of paraesophageal hiatal hernia, with or without fundoplicationLaparoscopic alternative to open repair; related as a minimally invasive approach option

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208800000XUrology PhysicianA urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has compreh…
    347D00000XTrainAn organization or business licensed to provide passenger train service, including light rail, subway, and traditional services.
    2278P1006XPulmonary Function Technologist Certified Respiratory TherapistAn individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Tec…
    251F00000XHome Infusion AgencyAgencies · Home Infusion
    163WC1400XCollege Health Registered NurseNursing Service Providers · Registered Nurse

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    7 rows

    PolicyPayerEffective Date
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01
    Celiac Disease TestingOscar Health2026-10-01

    Related Codes

    CPT-43300-ESOPHAGEAL-RECONSTRUCTION-CERVICAL-APPROACH

    CPT 43300: Esophageal Repair or Reconstruction via Cervical Incision

    CPT-43305-ESOPHAGEAL-REPAIR-CERVICAL-APPROACH-TRACHEOESOPHAGEAL-FISTULA-REPAIR

    CPT 43305: Esophageal Repair via Cervical Approach

    CPT-43310-ESOPHAGEAL-RECONSTRUCTION-THORACOTOMY

    CPT 43310: Esophageal Repair or Reconstruction via Thoracotomy

    CPT-43312-ESOPHAGEAL-RECONSTRUCTION-TRACHEOESOPHAGEAL-FISTULA-REPAIR

    CPT 43312: Esophageal Reconstruction and Tracheoesophageal Fistula Repair

    CPT-43313-CONGENITAL-ESOPHAGEAL-RECONSTRUCTION-THORACOTOMY

    CPT 43313: Repair of Congenital Esophageal Defect via Thoracotomy

    CPT-43314-CONGENITAL-ESOPHAGEAL-REPAIR-THORACOTOMY

    CPT 43314: Reconstruction of Congenital Esophageal Defect via Thoracotomy

    CPT-43320-LOWER-ESOPHAGUS-UPPER-STOMACH-REPAIR-OPEN-SURGERY

    CPT 43320: Plastic Repair of Lower Esophagus and Upper Stomach

    CPT-43325-DISTAL-ESOPHAGUS-REPAIR-WITH-FUNDIC-PATCH

    CPT 43325: Repair of Distal Esophagus with Fundic Patch

    CPT-43327-FUNDOPLASTY-OPEN-FUNDOPLICATION-ABDOMINAL-APPROACH

    CPT 43327: Partial or Complete Fundoplasty, Abdominal Approach

    CPT-43328-THORACIC-FUNDOPLASTY-FUNDOPLICATION-CHEST-APPROACH

    CPT 43328: Partial or Complete Fundoplasty via Thoracic Incision

    Showing 1–10 of 30

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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