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Billing code 43123: EsophagectomyMedicare rate & RVUs

Reports thoracic partial esophagectomy reconstructed with a colon or jejunal conduit and connected to the cervical esophagus.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $4,175.45 for 43123 nationally in a facility.

Medicare rate · 43123

Esophagectomy

Swap in your local Medicare rate.

Work RVUs
81.04
Total RVUs
125.01
Global days
090

National rate · 2026

$4,175.45

Facility setting, before claim adjustments.

See every locality for 43123 → · 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 43123 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 43123 covers

This operation removes a portion of the thoracic esophagus and restores the passage using a segment of colon or jejunum connected to the cervical esophagus. A surgeon performs it in an operating room, commonly for esophageal disease that requires segmental removal and reconstruction rather than removal of a small isolated lesion. The operative report should establish the resection site and extent, the bowel conduit used, and the location of the connection.

Select this code when the documented operation matches that resection and reconstruction, not merely because part of the esophagus was removed. The operative report should describe the conduit and cervical connection; a different reconstruction or a limited lesion excision points to a different code. Medicare treats the service as major surgery with 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% 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 43123 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

43123 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$3,780.80
Alaska*Unavailable$5,273.23
ArizonaUnavailable$4,052.73
ArkansasUnavailable$3,733.40
AtlantaUnavailable$4,333.43
AustinUnavailable$4,148.56
BakersfieldUnavailable$4,035.22
Baltimore/Surr. CntysUnavailable$4,437.99
BeaumontUnavailable$4,056.25
BrazoriaUnavailable$4,039.76

43123 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
43123 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 43123 rate is calculated

Each of 43123’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 · 43123

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 81.04Practice expense 23.52Malpractice 20.45

125.0100 adjusted RVUs×$33.4009 conversion factor=$4,175.45

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

Payment rules and modifiers for 43123

43123 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43123

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 · 43123

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

43123 without 51 · national facility

$4,175.45

Esophagectomy

43123-51 · Second procedure: 50%

$2,087.73

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

43123 compared with similar codes

Compare codes

43123 vs 43121 vs 43117 vs 43118 vs 43100: national Medicare rates

Swap in your local Medicare rate.

  • 43123
    Esophagectomy · 81.04 wRVU
    —
  • 43121
    Partial esophagectomy · 50.14 wRVU
    —
  • 43117
    Partial esophagectomy · 56.06 wRVU
    —
  • 43118
    Partial esophagectomy · 65.39 wRVU
    —
  • 43100
    Esophageal excision · 9.42 wRVU
    —

How to choose

43121Partial esophagectomy
Both involve partial thoracic esophagectomy and a bowel conduit; distinguish them by the location of the conduit connection, cervical for 43123 versus intrathoracic for 43121.
43117Partial esophagectomy
43117 involves partial thoracic esophagectomy with primary repair. Use 43123 when the reconstruction uses a colon or jejunal conduit connected to the cervical esophagus.
43118Partial esophagectomy
43118 uses gastric reconstruction after partial thoracic esophagectomy. 43123 describes reconstruction with a colon or jejunal conduit and a cervical connection.
43100Esophageal excision
43100 is for excision of an esophageal lesion, not the thoracic segmental resection and bowel-conduit reconstruction represented by 43123.

Codes related to 43123

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

Codes related to 43123
CodeHow it relatesNational office range
Same family
43121Partial esophagectomyPartial thoracic resection with a bowel conduit connected within the thorax.No office rate
43122EsophagectomyRelated partial esophagectomy code; use the documented resection and reconstruction details to distinguish it.No office rate
43117Partial esophagectomyPartial thoracic esophagectomy with primary repair rather than bowel-conduit reconstruction.No office rate
43118Partial esophagectomyPartial thoracic esophagectomy with gastric reconstruction rather than a colon or jejunal conduit.No office rate
Used instead
43100Esophageal excisionFor excision of an esophageal lesion rather than the segmental resection and conduit reconstruction described here.No office rate

43123 billing questions

How is this code distinguished from 43121?

The key distinction is where the bowel conduit connects: 43123 describes a cervical connection, while 43121 describes an intrathoracic connection. Check the operative report for the anastomosis location.

Can a separate code be reported for the bowel conduit reconstruction?

The conduit reconstruction is part of the operation described by this code. The operative report should support the esophageal resection, conduit, and cervical connection.

Does this code have a 90-day global period?

Yes. The day-before preoperative visit and related postoperative care during the 90-day period are included.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.

May an assistant or co-surgeon be reported?

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

Should modifier 50 be used?

No. The anatomy and procedure are not suited to bilateral reporting, so modifier 50 is inappropriate.

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 43123PPRRVU2026_Oct_nonQPP.csv, line 5,127 (RVU26D)

Open CMS sourceHow we calculate rates

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