CPT code 43314: Tracheoesophageal repair, congenital anomaly2026 Medicare rate & RVUs

Medicare pays $2,871.48 for 43314 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 43314 covers

This code represents surgery to reconstruct the esophagus in a congenital tracheoesophageal condition. A canonical setting is repair of esophageal atresia with an associated tracheoesophageal fistula, usually performed by a pediatric surgeon or thoracic surgeon in an operating room. The operative work addresses the congenital connection or defect involving the esophagus and trachea; the operative report should make the congenital diagnosis and the reconstruction performed clear.

Report the code when the documented procedure matches congenital tracheoesophageal reconstruction, rather than an isolated congenital esophageal repair or a repair coded for a noncongenital fistula. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery 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 43314 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

43314 rates by state

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

How the 43314 rate is calculated

Each of 43314’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 43314

43314 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

43314 compared with similar codes

How to choose

43313Esophageal repairCongenital atresia repair

Both address congenital esophageal surgery, but 43314 is the tracheoesophageal reconstruction code. Select 43313 when the documented service is the distinct congenital esophagoplasty represented by that code.

43312Esophageal repairThoracic approach with fistula

This code describes esophageal repair with fistula repair; 43314 is for congenital tracheoesophageal reconstruction. Base the choice on the congenital anatomy and procedure documented.

43305Esophageal repairWith fistula repair

This is another esophageal repair code involving fistula repair. It is not interchangeable with 43314 when the operative service reconstructs a congenital tracheoesophageal abnormality.

Codes related to 43314

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