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CPT code 43289: Laparoscopic esophageal surgery, unlisted service2026 Medicare rate & RVUs

Reports a laparoscopic esophageal operation that lacks a dedicated CPT code, with Medicare payment determined by the contractor from claim documentation.

CMS RVU26DEffective Oct 1, 2026109 payment localities279 Medicare services in 2024

Medicare rate · 43289

Laparoscopic esophageal surgery, unlisted service

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 43289 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 43289 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43289 covers

This code is for a laparoscopic operation involving the esophagus when no specific CPT code describes the work performed. The operating surgeon reports the service, rather than a routine upper endoscopy or an ERCP. The operative report should identify the condition treated, laparoscopic steps, structures involved, and any reconstruction or device used. Explain why a named laparoscopic esophageal procedure code does not describe the operation so the Medicare contractor can evaluate the claim.

Medicare assigns carrier-priced status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period. 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 multiple-procedure reduction.

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.

Where 43289 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

43289 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

43289 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
43289 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 43289 rate is calculated

Each of 43289’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 · 43289

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 43289

The CMS indicators that decide how 43289 is paid alongside other services.

CMS payment indicators · 43289

Laparoscopic esophageal surgery, unlisted service

RuleCMS valueWhat it means
Global periodYYYThe Medicare contractor sets the global period.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

43289 without 50 · national facility

$0.00

Laparoscopic esophageal surgery, unlisted service

43289-50 · Bilateral: 150%

$0.00

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

43289 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 43289

    Laparoscopic esophageal surgery, unlisted service0 wRVU

    Not priced

  • 43279

    Heller myotomy, laparoscopic, fundoplasty if performed21.55 wRVU

    Not priced

  • 43280

    Fundoplasty, laparoscopic antireflux wrap17.65 wRVU

    Not priced

  • 43281

    Hernia repair, laparoscopic, without mesh25.94 wRVU

    Not priced

  • 43282

    Hernia repair, laparoscopic, with mesh29.35 wRVU

    Not priced

How to choose

43279Heller myotomyLaparoscopic, fundoplasty if performed
43279 describes a laparoscopic Heller myotomy. Use 43289 only when the operation is not represented by a specific code such as this one.
43280FundoplastyLaparoscopic antireflux wrap
43280 is the specific code for laparoscopic fundoplasty; 43289 is for a laparoscopic esophageal operation without a dedicated code.
43281Hernia repairLaparoscopic, without mesh
43281 describes laparoscopic paraesophageal hernia repair without mesh. Choose 43289 only when the operation does not match this or another specific code.
43282Hernia repairLaparoscopic, with mesh
43282 describes laparoscopic paraesophageal hernia repair with mesh. It is more specific than 43289 when that is the operation performed.

Codes related to 43289

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 43289
CodeHow it relatesNational office range
Used instead
43279Heller myotomy, laparoscopic, fundoplasty if performedUse the specific code when the laparoscopic operation is a Heller myotomy.No office rate
43280Fundoplasty, laparoscopic antireflux wrapUse this specific code for a laparoscopic fundoplasty.No office rate
43281Hernia repair, laparoscopic, without meshUse this specific code for laparoscopic paraesophageal hernia repair without mesh.No office rate
43282Hernia repair, laparoscopic, with meshUse this specific code for laparoscopic paraesophageal hernia repair with mesh.No office rate
43283Esophageal lengthening, laparoscopic Collis gastroplastyUse this specific code when the laparoscopic service is esophageal lengthening.No office rate

43289 billing questions

When should I report 43289 instead of a named laparoscopic esophageal code?

Use 43289 when no specific CPT code describes the laparoscopic operation performed. If the work matches a named procedure such as a Heller myotomy or fundoplasty, report that specific code instead.

What documentation should accompany this unlisted service?

Describe the condition treated, operative approach and steps, structures treated, and any reconstruction or device. Make clear why a specific laparoscopic esophageal code does not fit.

How does Medicare determine payment?

Status C means CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period.

How are multiple procedures in the same session treated?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

How should I report units?

This is an unlisted procedure code, not a per-step or dose-based service. Describe the complete operation in the claim 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 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

Open CMS sourceHow we calculate rates

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