Billing code 43124: EsophagectomyMedicare rate & RVUs

Medicare pays $3,553.52 for 43124 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 43124 covers

This code represents a major operation removing most or all of the esophagus through a chest incision, with the associated gastric resection and reconstruction specified for this procedure. It is typically performed by a thoracic or upper gastrointestinal surgeon in a hospital operating room. Common clinical contexts include esophageal cancer and selected severe benign disease when a limited resection is not appropriate. The operative report should establish the extent of esophageal removal, thoracic approach, stomach resection, and reconstruction performed.

Select this code from the operation actually documented, rather than from the diagnosis alone; distinguish it from partial esophagectomy and from total or near-total resections using a different approach or reconstruction. The procedure 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 other procedures are subject to the standard 50% multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require 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 43124 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

43124 rates by state

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

How the 43124 rate is calculated

Each of 43124’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.

Payment rules and modifiers for 43124

43124 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

43124 compared with similar codes

How to choose

43107Esophagectomy

This code involves a thoracotomy. Code 43107 describes total or near-total esophageal removal without a thoracotomy.

43117Partial esophagectomy

Code 43117 is for partial esophageal removal. Choose this code when the operative report supports total or near-total resection through a thoracotomy.

43112Esophagectomy

Both codes are in the total or near-total esophagectomy family. Check the operative report's reconstruction details and the code-specific configuration before choosing between them.

43100Esophageal excision

Code 43100 addresses excision of an esophageal lesion, not removal of most or all of the esophagus.

Codes related to 43124

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

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

Open CMS sourceHow we calculate rates