CPT code 43310: Esophageal repair, thoracic approach, no fistula2026 Medicare rate & RVUs in Missouri
Reports surgical repair of an esophageal injury or defect through a thoracic approach when the operation does not include tracheoesophageal fistula repair.
CMS doesn’t publish an office rate for 43310 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.
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On this page 9 sections
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 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 | $1,375.40 |
| Metropolitan St. Louis, MO | Unavailable | $1,385.07 |
| Rest of Missouri | Unavailable | $1,349.32 |
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.
How the rate is built · 43310
RVUs × geographic indexes × conversion factor
Work25.60
25.60 RVUs× 1.000 GPCI
Practice expense9.89
9.89 RVUs× 1.000 GPCI
Malpractice6.44
6.44 RVUs× 1.000 GPCI
Adjusted RVUs
41.9300
Conversion factor
$33.4009
Medicare rate
$1,400.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43310
43310 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43310
Esophageal repair, thoracic approach, no fistula
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43310
Esophageal repair, thoracic approach, no fistula
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43310 without 51 · national facility
$1,400.50
Esophageal repair, thoracic approach, no fistula
43310-51 · Second procedure: 50%
$700.25
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43310 compared with similar codes
Compare codes · National
4 codes, side by side
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.
43310 billing questions
How does 43310 differ from 43300?
43310 is for repair through a thoracic approach; 43300 is the corresponding repair through a cervical approach. The operative report must support the route used.
When should 43312 be used instead?
Use 43312 when the thoracic esophageal operation also repairs a tracheoesophageal fistula. 43310 describes thoracic repair without that fistula repair.
What documentation supports 43310?
The operative report should identify the esophageal defect, describe the repair, document the thoracic approach, and clarify whether a tracheoesophageal fistula was repaired.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this single esophageal repair.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
Show the CMS file lines behind this rate
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