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CPT code 43341: Esophageal anastomosis, intrathoracic approach2026 Medicare rate & RVUs

Reports reconstruction connecting the esophagus to intestine through an intrathoracic approach, commonly after esophageal resection when intestinal tissue is used.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,337.71 for 43341 nationally in a facility.

Medicare rate · 43341

Esophageal anastomosis, intrathoracic approach

Office or facility?

Work RVUs
23.62
Total RVUs
40.05
Global days
090

National rate · 2026

$1,337.71

Facility setting, before claim adjustments.

See every locality for 43341 →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 43341 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 43341 covers

This operation joins the esophagus to an intestinal segment through an intrathoracic approach to restore digestive continuity. A surgeon may perform it during reconstruction after esophageal resection when the stomach is not used for the connection. The operative report should make clear that intestine was joined to the esophagus and identify the thoracic route; a cervical approach is reported with 43340 instead.

Report one unit for the documented reconstruction, with the operative note supporting the anastomosis, tissues joined, and approach. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. 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 43341 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

43341 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,207.60
AlaskaUnavailable$1,665.52
ArizonaUnavailable$1,298.20
ArkansasUnavailable$1,191.85
Atlanta, GAUnavailable$1,385.68
Austin, TXUnavailable$1,336.87
Bakersfield, CAUnavailable$1,308.43
Baltimore area, MDUnavailable$1,423.04
Beaumont, TXUnavailable$1,292.10
Brazoria, TXUnavailable$1,297.07

43341 rates by state

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

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Explore a state

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
43341 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 43341 rate is calculated

Each of 43341’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 · 43341

RVUs × geographic indexes × conversion factor

Office or facility?

Work23.62

23.62 RVUs× 1.000 GPCI

Practice expense10.47

10.47 RVUs× 1.000 GPCI

Malpractice5.96

5.96 RVUs× 1.000 GPCI

Adjusted RVUs

40.0500

Conversion factor

$33.4009

Medicare rate

$1,337.71

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

Payment rules and modifiers for 43341

43341 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43341

Esophageal anastomosis, intrathoracic approach

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 · 43341

Esophageal anastomosis, intrathoracic approach

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

43341 without 51 · national facility

$1,337.71

Esophageal anastomosis, intrathoracic approach

43341-51 · Second procedure: 50%

$668.86

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

43341 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 43341

    Esophageal anastomosis, intrathoracic approach23.62 wRVU

    Not priced

  • 43340

    Esophageal reconstruction, intestinal connection22.42 wRVU

    Not priced

  • 43320

    Esophageal reconstruction, stomach connection22.73 wRVU

    Not priced

  • 43325

    Anastomosis revision, abdominal approach22.04 wRVU

    Not priced

How to choose

43340Esophageal reconstructionIntestinal connection
Both codes describe esophagoenterostomy; select 43341 for the intrathoracic approach and 43340 for the cervical approach.
43320Esophageal reconstructionStomach connection
43320 connects the esophagus to the stomach. Use 43341 when intestine, rather than the stomach, is joined to the esophagus.
43325Anastomosis revisionAbdominal approach
43325 describes revision involving an esophagus-to-stomach connection. It is not the code for creating an intrathoracic esophagus-to-intestine anastomosis.

Codes related to 43341

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

Codes related to 43341
CodeHow it relatesNational office range
Same family
43340Esophageal reconstruction, intestinal connectionEsophagoenterostomy through a cervical rather than intrathoracic approach.No office rate
Used instead
43320Esophageal reconstruction, stomach connectionEsophagus-to-stomach reconstruction rather than an intestinal anastomosis.No office rate
43300Esophageal repair, cervical approach, no fistula repairEsophageal repair for a different operative circumstance without intestinal reconstruction.No office rate

43341 billing questions

How is 43341 distinguished from 43340?

43341 describes the intrathoracic approach. Use 43340 when the esophagoenteric anastomosis is performed through a cervical approach.

When would an esophagogastrostomy code be used instead?

Use an esophagogastrostomy code when the esophagus is joined to the stomach. 43341 is for a connection to intestine.

What operative documentation supports 43341?

Document the intestinal tissue joined to the esophagus, the completed anastomosis, and the intrathoracic approach. The record should distinguish this reconstruction from a cervical approach or a stomach-based connection.

Does the procedure have a global period?

Yes. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant surgeon or co-surgeon be paid?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Should modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.

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 43341PPRRVU2026_Oct_nonQPP.csv, line 5,238 (RVU26D)

Open CMS sourceHow we calculate rates

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