CPT code 43331: Esophageal myotomy, thoracic approach2026 Medicare rate & RVUs

Medicare pays $1,282.26 for 43331 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 43331 covers

This operation divides the esophageal muscle through a thoracic approach to relieve impaired passage, most commonly in a patient with achalasia. A thoracic or general surgeon typically performs it in a hospital operating room. The surgeon may add a fundoplasty during the same operation; that option is encompassed by this service rather than treated as a separate fundoplasty procedure.

Select this code based on the thoracic route and the operative work, not on disease severity. The operative report should identify the approach, the myotomy performed, and any fundoplasty. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this single esophageal operation. 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 43331 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

43331 rates by state

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

How the 43331 rate is calculated

Each of 43331’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 43331

43331 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

43331 compared with similar codes

How to choose

43330Esophageal myotomyAbdominal approach

Choose 43331 for the thoracic route and 43330 for the abdominal route; the access approach, not the diagnosis, distinguishes them.

43279Heller myotomyLaparoscopic, fundoplasty if performed

This code represents a laparoscopic Heller-type myotomy. Use 43331 when the documented operation uses a thoracic approach.

43499Esophageal procedureUnlisted

This is an unlisted esophageal procedure code that may be used for POEM. It is not the code for a thoracic surgical myotomy.

Codes related to 43331

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