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CPT code 43320: Esophageal reconstruction, stomach connection2026 Medicare rate & RVUs

Reports surgical reconstruction connecting the esophagus to the stomach, commonly when the stomach serves as a conduit after esophageal resection.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,307.98 for 43320 nationally in a facility.

Medicare rate · 43320

Esophageal reconstruction, stomach connection

Office or facility?

Work RVUs
22.73
Total RVUs
39.16
Global days
090

National rate · 2026

$1,307.98

Facility setting, before claim adjustments.

See every locality for 43320 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 43320 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43320 covers

A surgeon creates a connection between the esophagus and stomach, often using the stomach to restore continuity after part of the esophagus has been removed. The operation is performed in a surgical setting by a thoracic or gastrointestinal surgeon. A pyloroplasty may also be performed as part of the reconstruction and is included in this service.

Report this code when the operative record supports creation of the esophagus-to-stomach connection; document the reconstruction, the anatomy involved, and any associated pyloroplasty. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this single reconstruction. Assistant-at-surgery payment may be available; 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 43320 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

43320 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,176.63
AlaskaUnavailable$1,618.87
ArizonaUnavailable$1,268.02
ArkansasUnavailable$1,160.74
Atlanta, GAUnavailable$1,356.61
Austin, TXUnavailable$1,306.40
Bakersfield, CAUnavailable$1,276.19
Baltimore area, MDUnavailable$1,393.49
Beaumont, TXUnavailable$1,262.45
Brazoria, TXUnavailable$1,266.26

43320 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
43320 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 43320 rate is calculated

Each of 43320’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 · 43320

RVUs × geographic indexes × conversion factor

Office or facility?

Work22.73

22.73 RVUs× 1.000 GPCI

Practice expense10.35

10.35 RVUs× 1.000 GPCI

Malpractice6.08

6.08 RVUs× 1.000 GPCI

Adjusted RVUs

39.1600

Conversion factor

$33.4009

Medicare rate

$1,307.98

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 43320

43320 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43320

Esophageal reconstruction, stomach connection

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 43320

Esophageal reconstruction, stomach connection

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43320 without 51 · national facility

$1,307.98

Esophageal reconstruction, stomach connection

43320-51 · Second procedure: 50%

$653.99

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%).

When to use modifier 51

43320 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 43320

    Esophageal reconstruction, stomach connection22.73 wRVU

    Not priced

  • 43325

    Anastomosis revision, abdominal approach22.04 wRVU

    Not priced

  • 43340

    Esophageal reconstruction, intestinal connection22.42 wRVU

    Not priced

  • 43327

    Fundoplasty, laparoscopic approach13.02 wRVU

    Not priced

How to choose

43325Anastomosis revisionAbdominal approach
This code creates an esophagus-to-stomach connection. Code 43325 describes revision of an existing esophagogastric anastomosis.
43340Esophageal reconstructionIntestinal connection
Choose 43320 when the esophagus is connected to the stomach; 43340 is for connection to intestine.
43327FundoplastyLaparoscopic approach
Code 43327 describes laparoscopic esophagogastric fundoplasty, an antireflux operation rather than reconstruction of esophageal continuity.

Codes related to 43320

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

Codes related to 43320
CodeHow it relatesNational office range
Used instead
43340Esophageal reconstruction, intestinal connectionEsophageal reconstruction connecting to intestine rather than the stomach.No office rate
43341Esophageal anastomosis, intrathoracic approachAn esophagoenterostomy option when the reconstruction uses an intestinal connection.No office rate

43320 billing questions

When should this code be selected instead of an esophagoenterostomy code?

Use this code when the reconstruction connects the esophagus to the stomach. Esophagoenterostomy codes describe a connection to intestine instead.

Is pyloroplasty separately reported with this reconstruction?

A pyloroplasty performed as part of this reconstruction is included in the service.

Does modifier 50 apply?

No. The procedure creates one esophagus-to-stomach connection, not a bilateral service.

What documentation supports reporting this code?

The operative report should identify the esophagus-to-stomach reconstruction, the anatomy connected, and the role of the stomach in restoring continuity.

What postoperative care is included in the global period?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. 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
RVUs for 43320PPRRVU2026_Oct_nonQPP.csv, line 5,224 (RVU26D)

Open CMS sourceHow we calculate rates

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