FeeBase
Log inGet started
Menu

CPT code 43400: Varix ligation, thoracic or abdominal approach2026 Medicare rate & RVUs

Reports surgical ligation of esophageal varices through a thoracic or abdominal approach, rather than endoscopic injection or band treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,420.21 for 43400 nationally in a facility.

Medicare rate · 43400

Varix ligation, thoracic or abdominal approach

Office or facility?

Work RVUs
24.96
Total RVUs
42.52
Global days
090

National rate · 2026

$1,420.21

Facility setting, before claim adjustments.

See every locality for 43400 →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 43400 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 43400 covers

This operation surgically ligates esophageal varices, typically in a patient with portal hypertension and variceal bleeding. A surgeon reaches the esophagus through a thoracic or abdominal approach to control the varices; this is distinct from treating them through an endoscope. The service is performed in an operative setting, rather than as routine endoscopic management of varices.

Report the code when the operative record supports surgical ligation of the esophageal veins and identifies the approach and treatment performed. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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 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 43400 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

43400 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,278.05
AlaskaUnavailable$1,760.66
ArizonaUnavailable$1,376.85
ArkansasUnavailable$1,260.87
Atlanta, GAUnavailable$1,473.31
Austin, TXUnavailable$1,417.57
Bakersfield, CAUnavailable$1,383.86
Baltimore area, MDUnavailable$1,512.90
Beaumont, TXUnavailable$1,371.65
Brazoria, TXUnavailable$1,374.59

43400 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
43400 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 43400 rate is calculated

Each of 43400’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 · 43400

RVUs × geographic indexes × conversion factor

Office or facility?

Work24.96

24.96 RVUs× 1.000 GPCI

Practice expense10.89

10.89 RVUs× 1.000 GPCI

Malpractice6.67

6.67 RVUs× 1.000 GPCI

Adjusted RVUs

42.5200

Conversion factor

$33.4009

Medicare rate

$1,420.21

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

Payment rules and modifiers for 43400

43400 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43400

Varix ligation, thoracic or abdominal 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 · 43400

Varix ligation, thoracic or abdominal 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

43400 without 51 · national facility

$1,420.21

Varix ligation, thoracic or abdominal approach

43400-51 · Second procedure: 50%

$710.11

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

43400 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 43400

    Varix ligation, thoracic or abdominal approach24.96 wRVU

    Not priced

  • 43405

    Esophageal transection, ligation or stapling24.11 wRVU

    Not priced

  • 43244

    Variceal ligation, esophageal or gastric varices4.29 wRVU

    Not priced

  • 43243

    Variceal injection, esophageal or gastric varices4.16 wRVU

    Not priced

How to choose

43405Esophageal transectionLigation or stapling
Both are surgical approaches to variceal control. Choose 43400 for surgical ligation of the veins; 43405 describes an esophageal ligation or stapling technique.
43244Variceal ligationEsophageal or gastric varices
43244 is endoscopic band treatment of esophageal or gastric varices. Use 43400 for surgical ligation through a thoracic or abdominal approach.
43243Variceal injectionEsophageal or gastric varices
43243 reports endoscopic injection treatment of varices. It is not the code for surgical ligation of esophageal veins.

Codes related to 43400

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

Codes related to 43400
CodeHow it relatesNational office range
Used instead
43405Esophageal transection, ligation or staplingA different surgical variceal procedure involving ligation or stapling of the esophagus.No office rate
43244Variceal ligation, esophageal or gastric varicesEndoscopic band treatment of esophageal or gastric varices, rather than surgical ligation.No office rate
43243Variceal injection, esophageal or gastric varicesEndoscopic injection treatment of esophageal or gastric varices.No office rate

43400 billing questions

How is this different from endoscopic variceal banding?

This code is for surgical ligation through a thoracic or abdominal approach. Endoscopic band treatment is reported with the applicable endoscopy code, such as 43244.

What documentation supports reporting this code?

The operative report should identify esophageal varices, the surgical approach, and the ligation performed. Documentation should make clear that treatment was surgical rather than endoscopic.

Can modifier 50 be used for varices on both sides?

No. Modifier 50 is inappropriate for this single esophageal operation.

How does the global period affect postoperative billing?

The code has a 90-day global period. The day-before preoperative visit and related postoperative care during the 90 days are included.

Can an assistant or co-surgeon be reported?

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

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 43400PPRRVU2026_Oct_nonQPP.csv, line 5,243 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 43400 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 43400 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist