CPT code 43310: Esophageal repair, thoracic approach, no fistula2026 Medicare rate & RVUs

Medicare pays $1,400.50 for 43310 nationally in a facility.

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

What 43310 covers

This code describes operative repair of an esophageal defect reached through the chest, without repair of a tracheoesophageal fistula. Thoracic or general surgeons may use it for a perforation or other esophageal injury requiring surgical closure or reconstruction. The operative report should establish the thoracic route and describe the defect and repair; an esophageal injury treated through a cervical approach belongs to a different code in this family.

Select the code based on the documented approach and whether a tracheoesophageal fistula is repaired, not simply on the diagnosis of an esophageal perforation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For other procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this single esophageal repair. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.

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 43310 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

43310 rates by state

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

How the 43310 rate is calculated

Each of 43310’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.

Payment rules and modifiers for 43310

43310 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

43310 compared with similar codes

How to choose

43300Esophageal repairCervical approach, no fistula repair

Choose 43300 when the esophageal repair is performed through a cervical approach. 43310 is the thoracic-approach repair without fistula repair.

43305Esophageal repairWith fistula repair

43305 describes cervical-approach repair with tracheoesophageal fistula repair. For a thoracic approach with fistula repair, compare 43312.

43312Esophageal repairThoracic approach with fistula

Both codes describe thoracic-approach repair; 43312 includes repair of a tracheoesophageal fistula, while 43310 does not.

Codes related to 43310

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

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