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Billing code 43122: EsophagectomyMedicare rate & RVUs

Reports partial esophageal resection through an abdominal or thoracoabdominal approach when reconstruction uses colon interposition or jejunal transfer.

CMS RVU26DEffective Oct 1, 2026109 payment localities89 Medicare services in 2024

Medicare pays $2,336.39 for 43122 nationally in a facility.

Medicare rate · 43122

Esophagectomy

Swap in your local Medicare rate.

Work RVUs
43.08
Total RVUs
69.95
Global days
090

National rate · 2026

$2,336.39

Facility setting, before claim adjustments.

See every locality for 43122 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 43122 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 43122 covers

This code describes removal of part of the esophagus through an abdominal or thoracoabdominal approach, with reconstruction using a segment of colon or jejunum. It may be used for conditions such as esophageal cancer when the operative plan requires this extent of resection and reconstruction. The procedure is performed by a surgeon in a hospital operating room; Medicare claims for this code are reported in the facility setting.

Select the code from the operative report’s documented resection extent, surgical approach, any proximal stomach removal, and reconstruction method. The report should establish that colon interposition or jejunal transfer was used, rather than a different reconstruction captured by a sibling code. This major surgery has 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 others at 50%. 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 43122 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

43122 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,112.02
Alaska*Unavailable$2,927.57
ArizonaUnavailable$2,267.54
ArkansasUnavailable$2,084.95
AtlantaUnavailable$2,422.24
AustinUnavailable$2,328.88
BakersfieldUnavailable$2,273.08
Baltimore/Surr. CntysUnavailable$2,484.47
BeaumontUnavailable$2,262.52
BrazoriaUnavailable$2,263.22

43122 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
43122 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 43122 rate is calculated

Each of 43122’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 · 43122

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 43.08Practice expense 16.00Malpractice 10.87

69.9500 adjusted RVUs×$33.4009 conversion factor=$2,336.39

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 43122

43122 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43122

Esophagectomy

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 · 43122

Esophagectomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

43122 without 51 · national facility

$2,336.39

Esophagectomy

43122-51 · Second procedure: 50%

$1,168.20

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

43122 compared with similar codes

Compare codes

43122 vs 43121 vs 43117 vs 43107 vs 43100: national Medicare rates

Swap in your local Medicare rate.

  • 43122
    Esophagectomy · 43.08 wRVU
    —
  • 43121
    Partial esophagectomy · 50.14 wRVU
    —
  • 43117
    Partial esophagectomy · 56.06 wRVU
    —
  • 43107
    Esophagectomy · 50.75 wRVU
    —
  • 43100
    Esophageal excision · 9.42 wRVU
    —

How to choose

43121Partial esophagectomy
Both describe partial esophagectomy variants involving an abdominal or thoracoabdominal approach. The reconstruction documented in the operative report distinguishes this code from 43121.
43117Partial esophagectomy
43117 represents a partial esophagectomy through a thoracic approach. This code is the abdominal or thoracoabdominal variant with colon interposition or jejunal transfer.
43107Esophagectomy
43107 is for total or near-total esophageal removal; this code is for partial removal with the specified intestinal reconstruction.
43100Esophageal excision
43100 describes excision of an esophageal lesion, not the partial esophagectomy and intestinal reconstruction reported with this code.

Codes related to 43122

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

Codes related to 43122
CodeHow it relatesNational office range
Same family
43121Partial esophagectomyPartial esophagectomy variant distinguished by its reconstruction details.No office rate
43123EsophagectomyAnother partial esophagectomy variant; select by the documented approach and reconstruction.No office rate
43117Partial esophagectomyPartial esophagectomy through a thoracic approach.No office rate
43116EsophagectomyPartial esophagectomy through a cervical approach.No office rate
Used instead
43107EsophagectomyFor total or near-total rather than partial esophageal removal.No office rate
43100Esophageal excisionFor excision of an esophageal lesion rather than partial esophagectomy.No office rate

43122 billing questions

How is this code distinguished from 43121?

The operative approach and reconstruction determine the choice. This code represents the variant using colon interposition or jejunal transfer; 43121 describes a different reconstruction variant.

What operative details support reporting this code?

Document the portion of esophagus removed, abdominal or thoracoabdominal approach, any proximal gastrectomy, and whether colon or jejunum was used for reconstruction.

Can the intestinal reconstruction be reported separately?

The code includes the specified colon interposition or jejunal transfer as part of the esophagectomy service. Do not separately report that same reconstruction as though it were an independent service.

How does the 90-day global period affect postoperative claims?

The day-before preoperative visit and 90 days of related postoperative care are included in the global surgical period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.

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

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.

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 43122PPRRVU2026_Oct_nonQPP.csv, line 5,126 (RVU26D)

Open CMS sourceHow we calculate rates

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