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CPT code 43410: Esophageal repair, cervical approach2026 Medicare rate & RVUs

Reports operative repair of an esophageal wound reached through a cervical approach, such as repair of a traumatic or procedure-related laceration.

CMS RVU26DEffective Oct 1, 2026109 payment localities52 Medicare services in 2024

Medicare pays $902.16 for 43410 nationally in a facility.

Medicare rate · 43410

Esophageal repair, cervical approach

Office or facility?

Work RVUs
16
Total RVUs
27.01
Global days
090

National rate · 2026

$902.16

Facility setting, before claim adjustments.

See every locality for 43410 →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 43410 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 43410 covers

This operation repairs an injured or lacerated esophageal wall through a cervical approach. A surgeon typically performs it in an operating room when an esophageal wound requires operative closure, including a traumatic injury or an injury recognized during another procedure. The operative approach distinguishes this service from repair reached through a thoracic or abdominal approach.

Report 43410 for the wound repair itself, with operative documentation identifying the esophageal injury and cervical approach. Closure of an esophagostomy is a different service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are paid at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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 43410 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

43410 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$832.04
AlaskaUnavailable$1,153.10
ArizonaUnavailable$881.93
ArkansasUnavailable$823.42
Atlanta, GAUnavailable$924.10
Austin, TXUnavailable$911.11
Bakersfield, CAUnavailable$909.55
Baltimore area, MDUnavailable$950.37
Beaumont, TXUnavailable$870.55
Brazoria, TXUnavailable$886.63

43410 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
43410 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 43410 rate is calculated

Each of 43410’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 · 43410

RVUs × geographic indexes × conversion factor

Office or facility?

Work16.00

16.00 RVUs× 1.000 GPCI

Practice expense8.67

8.67 RVUs× 1.000 GPCI

Malpractice2.34

2.34 RVUs× 1.000 GPCI

Adjusted RVUs

27.0100

Conversion factor

$33.4009

Medicare rate

$902.16

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

Payment rules and modifiers for 43410

43410 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43410

Esophageal repair, cervical 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 · 43410

Esophageal repair, cervical 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

43410 without 51 · national facility

$902.16

Esophageal repair, cervical approach

43410-51 · Second procedure: 50%

$451.08

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

43410 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 43410

    Esophageal repair, cervical approach16 wRVU

    Not priced

  • 43415

    Esophageal repair, thoracic or abdominal approach43.76 wRVU

    Not priced

  • 43420

    Esophageal repair, cervical approach16.36 wRVU

    Not priced

  • 43425

    Fistula repair, esophageal opening24.41 wRVU

    Not priced

How to choose

43415Esophageal repairThoracic or abdominal approach
Both codes repair an esophageal wound. Use 43410 for a cervical approach and 43415 for a thoracic or abdominal approach.
43420Esophageal repairCervical approach
43420 addresses closure of an esophagostomy through a cervical approach; 43410 repairs an esophageal wound.
43425Fistula repairEsophageal opening
43425 addresses closure of an esophagostomy through a thoracic or abdominal approach; 43410 is cervical wound repair.

Codes related to 43410

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

Codes related to 43410
CodeHow it relatesNational office range
Same family
43415Esophageal repair, thoracic or abdominal approachEsophageal wound repair through a thoracic or abdominal approach.No office rate
43420Esophageal repair, cervical approachClosure of an esophagostomy through a cervical approach, rather than repair of a wound.No office rate
43425Fistula repair, esophageal openingClosure of an esophagostomy through a thoracic or abdominal approach.No office rate

43410 billing questions

How does 43410 differ from 43415?

Both codes describe repair of an esophageal wound. Choose 43410 when the repair uses a cervical approach; 43415 is for a thoracic or abdominal approach.

Can 43410 be used to close an esophagostomy?

No. This code describes repair of an esophageal wound; closure of an esophagostomy is a distinct procedure. The operative report should identify what opening was repaired.

Is modifier 50 appropriate for 43410?

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

What documentation supports reporting 43410?

Document the esophageal wound and the cervical approach used to repair it. The operative report should make clear that the service was wound repair, rather than esophagostomy closure.

What is included in the Medicare global period?

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

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 43410PPRRVU2026_Oct_nonQPP.csv, line 5,246 (RVU26D)

Open CMS sourceHow we calculate rates

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