CPT code 43289: Laparoscopic esophageal surgery, unlisted service2026 Medicare rate & RVUs in Missouri
Reports a laparoscopic esophageal operation that lacks a dedicated CPT code, with Medicare payment determined by the contractor from claim documentation.
CMS doesn’t publish an office rate for 43289 in Missouri.
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
On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician 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).
43289 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
Fee sheets · Coming soon
Put 43289 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist