CPT code 43415: Esophageal repair, thoracic or abdominal approach2026 Medicare rate & RVUs in New Mexico
Open repair of an esophageal wound through a thoracic or abdominal approach, typically reported for operative treatment of an injury or perforation.
In New Mexico, Medicare pays $2,439.90 for 43415 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43415 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 43415 covers
This code describes operative repair of an esophageal wound reached through the chest or abdomen. It may be used for a traumatic injury or an esophageal perforation requiring open surgical closure. A thoracic or general surgeon typically performs the repair in a hospital operating room; the approach documented in the operative report distinguishes it from cervical repair.
Report the code when the surgeon’s work addresses a wound in the esophagus, not closure of a surgically created esophagostomy. The operative report should identify the injury, its location, the approach, and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. 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.
How New Mexico compares for 43415
Across 109 of 109 payment localities, the facility rate for 43415 runs from $2,135.49 in Wisconsin to $3,018.28 in Alaska. New Mexico pays $2,439.90. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$2,439.90
- Los Angeles, CA · California$2,458.00+$18.10
- Washington, DC area · District of Columbia$2,639.20+$199.30
- Miami, FL · Florida$3,000.82+$560.92
- Chicago, IL · Illinois$2,903.94+$464.04
- Manhattan, NY · New York$2,818.39+$378.49
- Alaska · Alaska$3,018.28+$578.38
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,181.80 |
| ArkansasArkansas | — | $2,153.68 |
| ArizonaArizona | — | $2,343.46 |
| Bakersfield, CACalifornia | — | $2,354.71 |
| Chico, CACalifornia | — | $2,324.94 |
| El Centro, CACalifornia | — | $2,326.78 |
| Fresno, CACalifornia | — | $2,324.94 |
| Hanford, CACalifornia | — | $2,324.94 |
| Madera, CACalifornia | — | $2,324.94 |
| Merced, CACalifornia | — | $2,324.94 |
| Modesto, CACalifornia | — | $2,324.94 |
| Napa, CACalifornia | — | $2,511.79 |
| Oxnard, CACalifornia | — | $2,423.34 |
| Redding, CACalifornia | — | $2,324.94 |
| Rest of CaliforniaCalifornia | — | $2,324.94 |
| Riverside, CACalifornia | — | $2,442.98 |
| Sacramento, CACalifornia | — | $2,391.92 |
| Salinas, CACalifornia | — | $2,382.27 |
| San Diego, CACalifornia | — | $2,404.67 |
| Marin County, CACalifornia | — | $2,594.38 |
| San Francisco, CACalifornia | — | $2,581.88 |
| San Benito County, CACalifornia | — | $2,663.35 |
| Santa Clara County, CACalifornia | — | $2,612.23 |
| San Luis Obispo, CACalifornia | — | $2,350.11 |
| Santa Cruz, CACalifornia | — | $2,400.43 |
| Santa Maria, CACalifornia | — | $2,381.98 |
| Santa Rosa, CACalifornia | — | $2,421.19 |
| Stockton, CACalifornia | — | $2,324.94 |
| Vallejo, CACalifornia | — | $2,493.77 |
| Visalia, CACalifornia | — | $2,324.94 |
| Yuba City, CACalifornia | — | $2,324.94 |
| ColoradoColorado | — | $2,389.01 |
| ConnecticutConnecticut | — | $2,566.07 |
| DelawareDelaware | — | $2,377.69 |
| Fort Lauderdale, FLFlorida | — | $2,719.30 |
| Rest of FloridaFlorida | — | $2,573.78 |
| Atlanta, GAGeorgia | — | $2,502.22 |
| Rest of GeorgiaGeorgia | — | $2,421.96 |
| Hawaii, Guam, HIHawaii | — | $2,339.90 |
| IowaIowa | — | $2,143.06 |
| IdahoIdaho | — | $2,173.94 |
| East St. Louis, ILIllinois | — | $2,740.63 |
| Rest of IllinoisIllinois | — | $2,570.68 |
| Suburban Chicago, ILIllinois | — | $2,724.48 |
| IndianaIndiana | — | $2,182.81 |
| KansasKansas | — | $2,175.97 |
| KentuckyKentucky | — | $2,318.34 |
| New Orleans, LALouisiana | — | $2,430.04 |
| Rest of LouisianaLouisiana | — | $2,331.81 |
| Metropolitan Boston, MAMassachusetts | — | $2,547.55 |
| Rest of MassachusettsMassachusetts | — | $2,394.30 |
| Baltimore area, MDMaryland | — | $2,567.81 |
| Rest of MarylandMaryland | — | $2,406.03 |
| Rest of MaineMaine | — | $2,228.73 |
| Southern Maine, MEMaine | — | $2,273.59 |
| Detroit, MIMichigan | — | $2,646.34 |
| Rest of MichiganMichigan | — | $2,411.08 |
| MinnesotaMinnesota | — | $2,172.63 |
| Metropolitan Kansas City, MOMissouri | — | $2,370.40 |
| Metropolitan St. Louis, MOMissouri | — | $2,387.20 |
| Rest of MissouriMissouri | — | $2,324.23 |
| MississippiMississippi | — | $2,237.23 |
| MontanaMontana | — | $2,413.82 |
| North CarolinaNorth Carolina | — | $2,242.59 |
| North DakotaNorth Dakota | — | $2,196.11 |
| NebraskaNebraska | — | $2,140.76 |
| New HampshireNew Hampshire | — | $2,392.58 |
| Northern New JerseyNew Jersey | — | $2,625.27 |
| Rest of New JerseyNew Jersey | — | $2,562.52 |
| NevadaNevada | — | $2,353.72 |
| NYC suburbs and Long Island, NYNew York | — | $2,933.85 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,613.14 |
| Queens, NYNew York | — | $2,777.14 |
| Rest of New YorkNew York | — | $2,276.07 |
| OhioOhio | — | $2,366.58 |
| OklahomaOklahoma | — | $2,269.93 |
| Portland, OROregon | — | $2,408.75 |
| Rest of OregonOregon | — | $2,302.99 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,535.83 |
| Rest of PennsylvaniaPennsylvania | — | $2,346.34 |
| Puerto RicoPuerto Rico | — | $2,415.47 |
| Rhode IslandRhode Island | — | $2,421.92 |
| South CarolinaSouth Carolina | — | $2,314.92 |
| South DakotaSouth Dakota | — | $2,170.37 |
| TennesseeTennessee | — | $2,191.03 |
| Austin, TXTexas | — | $2,409.49 |
| Beaumont, TXTexas | — | $2,335.77 |
| Brazoria, TXTexas | — | $2,340.07 |
| Dallas, TXTexas | — | $2,373.15 |
| Fort Worth, TXTexas | — | $2,372.07 |
| Galveston, TXTexas | — | $2,358.90 |
| Houston, TXTexas | — | $2,560.42 |
| Rest of TexasTexas | — | $2,349.04 |
| UtahUtah | — | $2,341.93 |
| VirginiaVirginia | — | $2,296.49 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,415.47 |
| VermontVermont | — | $2,227.03 |
| Rest of WashingtonWashington | — | $2,376.68 |
| King County, WAWashington | — | $2,553.17 |
| WisconsinWisconsin | — | $2,135.49 |
| West VirginiaWest Virginia | — | $2,496.39 |
| WyomingWyoming | — | $2,318.94 |
43415 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 43415 rate is calculated
Each of 43415’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 · 43415
RVUs × geographic indexes × conversion factor
Work43.76
43.76 RVUs× 1.000 GPCI
Practice expense17.52
17.52 RVUs× 1.000 GPCI
Malpractice11.01
11.01 RVUs× 1.000 GPCI
Adjusted RVUs
72.2900
Conversion factor
$33.4009
Medicare rate
$2,414.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,247
- Code
- 43415
- Physician work
- 43.76
- Practice expense
- 17.52
- Malpractice
- 11.01
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.76 | × 1.000 | 43.7600 |
| Practice expense | 17.52 | × 0.917 | 16.0658 |
| Malpractice | 11.01 | × 1.201 | 13.2230 |
| Total RVUs | 73.0489 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$2439.90
Facility: (43.76 × 1 + 17.52 × 0.917 + 11.01 × 1.201) × $33.4009 = $2439.90
Payment rules and modifiers for 43415
43415 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43415
Esophageal repair, thoracic or abdominal approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43415
Esophageal repair, 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43415 without 51 · national facility
$2,414.55
Esophageal repair, thoracic or abdominal approach
43415-51 · Second procedure: 50%
$1,207.28
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%).
How 43415 has changed in New Mexico
43415 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,439.90 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,439.90 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,439.90 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,439.90 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,470.99 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,470.99 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,470.99 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,470.99 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,548.15 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,548.15 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,548.15 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,548.15 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,506.56 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,570.26 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,570.26 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,570.26 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,570.26 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,596.64 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,596.64 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,596.64 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,596.64 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,600.49 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,600.49 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,600.49 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,600.49 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,702.79 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,702.79 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,702.79 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,702.79 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,729.25 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,729.25 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,729.25 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,729.25 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,729.10 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,729.10 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,729.10 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,729.10 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,695.88 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,695.88 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,695.88 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,695.88 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,686.14 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,686.14 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,686.14 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,686.14 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,684.56 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,684.56 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,671.20 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,671.20 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,635.35 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,635.35 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,635.35 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,635.35 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,546.25 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,546.25 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,546.25 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,546.25 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
43415 billing questions
How does this differ from 43410?
43415 is for repair through a thoracic or abdominal approach. 43410 is the cervical-approach repair.
Can this be used to close an esophagostomy?
No. Closure of a surgically created esophagostomy is described by codes such as 43420 or 43425, depending on the approach.
What documentation supports reporting 43415?
The operative report should establish that an esophageal wound was repaired and document its location, the thoracic or abdominal approach, and the repair performed.
How does the global period affect billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Should modifier 50 be appended for an esophageal wound?
No. CMS identifies bilateral adjustment as inappropriate for this code because of the 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
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