CPT code 43314: Tracheoesophageal repair, congenital anomaly2026 Medicare rate & RVUs in Oregon
Operative reconstruction for a congenital tracheoesophageal abnormality, such as esophageal atresia with a tracheoesophageal fistula, is reported with this code.
CMS doesn’t publish an office rate for 43314 in Oregon.
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 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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | $2,853.80 |
| Rest of Oregon | Unavailable | $2,730.33 |
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.
How the rate is built · 43314
RVUs × geographic indexes × conversion factor
Work52.09
52.09 RVUs× 1.000 GPCI
Practice expense19.92
19.92 RVUs× 1.000 GPCI
Malpractice13.96
13.96 RVUs× 1.000 GPCI
Adjusted RVUs
85.9700
Conversion factor
$33.4009
Medicare rate
$2,871.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43314
43314 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43314
Tracheoesophageal repair, congenital anomaly
| 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 · 43314
Tracheoesophageal repair, congenital anomaly
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
43314 without 51 · national facility
$2,871.48
Tracheoesophageal repair, congenital anomaly
43314-51 · Second procedure: 50%
$1,435.74
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%).
43314 compared with similar codes
Compare codes · National
4 codes, side by side
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.
43314 billing questions
How is this different from 43313?
Use 43314 for congenital tracheoesophageal reconstruction, such as repair involving an associated tracheoesophageal fistula. Code 43313 is the nearby congenital esophagoplasty code for a different documented service.
Can this be reported with a separate fistula repair code?
The procedure may include repair of the congenital tracheoesophageal connection. Review the operative work before separately reporting another repair code, and do not separately represent work already included in the reconstruction.
What documentation supports reporting 43314?
The operative report should identify the congenital tracheoesophageal condition and describe the esophageal reconstruction and any associated fistula repair. A diagnosis alone does not establish which procedure was performed.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS also applies the standard multiple procedure reduction when other procedures are performed in the same session.
May an assistant or co-surgeon be reported?
CMS indicates that an assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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