No office rate
Choose 43300 when the esophageal repair is performed through a cervical approach. 43310 is the thoracic-approach repair without fistula repair.
On this page
CMS RVU26D · Effective 2026-10-01
43310 Esophageal repair Medicare reimbursement rates
Reports surgical repair of an esophageal injury or defect through a thoracic approach when the operation does not include tracheoesophageal fistula repair. Compare 43310 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 43310?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 43310 pays more and less
Esophageal surgery
About 43310: Thoracic esophageal repair without fistula repair
Reports surgical repair of an esophageal injury or defect through a thoracic approach when the operation does not include tracheoesophageal fistula repair.
This code describes operative repair of an esophageal defect reached through the chest, without repair of a tracheoesophageal fistula. Thoracic or general surgeons may use it for a perforation or other esophageal injury requiring surgical closure or reconstruction. The operative report should establish the thoracic route and describe the defect and repair; an esophageal injury treated through a cervical approach belongs to a different code in this family.
Select the code based on the documented approach and whether a tracheoesophageal fistula is repaired, not simply on the diagnosis of an esophageal perforation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For other procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this single esophageal repair. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 43310
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU25.60 · 61%
- Practice expense (office) RVU9.89 · 24%
- Malpractice RVU6.44 · 15%
14
Medicare services in 2024 · #6101 by national volume
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.
43310 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
43305 describes cervical-approach repair with tracheoesophageal fistula repair. For a thoracic approach with fistula repair, compare 43312.
No office rate
Both codes describe thoracic-approach repair; 43312 includes repair of a tracheoesophageal fistula, while 43310 does not.
See how rates vary across the country
43310 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 43310 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1265.85 |
| Alaska* | Office Unavailable | Facility $1752.92 |
| Arizona | Office Unavailable | Facility $1359.28 |
| Arkansas | Office Unavailable | Facility $1249.60 |
| Atlanta | Office Unavailable | Facility $1451.59 |
| Austin | Office Unavailable | Facility $1396.85 |
| Bakersfield | Office Unavailable | Facility $1364.35 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1489.27 |
| Beaumont | Office Unavailable | Facility $1355.50 |
| Brazoria | Office Unavailable | Facility $1357.04 |
| Chicago | Office Unavailable | Facility $1686.69 |
| Chico | Office Unavailable | Facility $1346.94 |
| Colorado | Office Unavailable | Facility $1384.79 |
| Connecticut | Office Unavailable | Facility $1488.21 |
| Dallas | Office Unavailable | Facility $1376.33 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1529.78 |
| Delaware | Office Unavailable | Facility $1379.09 |
| Detroit | Office Unavailable | Facility $1536.50 |
| East St. Louis | Office Unavailable | Facility $1592.19 |
| El Centro | Office Unavailable | Facility $1348.02 |
| Fort Lauderdale | Office Unavailable | Facility $1578.60 |
| Fort Worth | Office Unavailable | Facility $1375.82 |
| Fresno | Office Unavailable | Facility $1346.94 |
| Galveston | Office Unavailable | Facility $1368.03 |
| Hanford-Corcoran | Office Unavailable | Facility $1346.94 |
| Hawaii, Guam | Office Unavailable | Facility $1355.20 |
| Houston | Office Unavailable | Facility $1485.91 |
| Idaho | Office Unavailable | Facility $1260.71 |
| Indiana | Office Unavailable | Facility $1265.82 |
| Iowa | Office Unavailable | Facility $1242.71 |
| Kansas | Office Unavailable | Facility $1262.10 |
| Kentucky | Office Unavailable | Facility $1345.55 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1423.73 |
| Madera | Office Unavailable | Facility $1346.94 |
| Manhattan | Office Unavailable | Facility $1634.79 |
| Merced | Office Unavailable | Facility $1346.94 |
| Metropolitan Boston | Office Unavailable | Facility $1475.98 |
| Metropolitan Kansas City | Office Unavailable | Facility $1375.40 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1470.95 |
| Metropolitan St. Louis | Office Unavailable | Facility $1385.07 |
| Miami | Office Unavailable | Facility $1742.93 |
| Minnesota | Office Unavailable | Facility $1258.65 |
| Mississippi | Office Unavailable | Facility $1298.44 |
| Modesto | Office Unavailable | Facility $1346.94 |
| Montana** | Office Unavailable | Facility $1400.07 |
| Napa | Office Unavailable | Facility $1453.59 |
| Nebraska | Office Unavailable | Facility $1241.27 |
| Nevada** | Office Unavailable | Facility $1364.91 |
| New Hampshire | Office Unavailable | Facility $1387.16 |
| New Mexico | Office Unavailable | Facility $1416.32 |
| New Orleans | Office Unavailable | Facility $1410.26 |
| North Carolina | Office Unavailable | Facility $1300.72 |
| North Dakota** | Office Unavailable | Facility $1272.73 |
| Northern Nj | Office Unavailable | Facility $1521.85 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1702.00 |
| Ohio | Office Unavailable | Facility $1373.48 |
| Oklahoma | Office Unavailable | Facility $1317.19 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1403.47 |
| Portland | Office Unavailable | Facility $1395.78 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1515.53 |
| Puerto Rico | Office Unavailable | Facility $1400.91 |
| Queens | Office Unavailable | Facility $1610.42 |
| Redding | Office Unavailable | Facility $1346.94 |
| Rest Of California | Office Unavailable | Facility $1346.94 |
| Rest Of Florida | Office Unavailable | Facility $1494.16 |
| Rest Of Georgia | Office Unavailable | Facility $1406.12 |
| Rest Of Illinois | Office Unavailable | Facility $1492.86 |
| Rest Of Louisiana | Office Unavailable | Facility $1353.48 |
| Rest Of Maine | Office Unavailable | Facility $1292.76 |
| Rest Of Maryland | Office Unavailable | Facility $1395.38 |
| Rest Of Massachusetts | Office Unavailable | Facility $1388.02 |
| Rest Of Michigan | Office Unavailable | Facility $1399.51 |
| Rest Of Missouri | Office Unavailable | Facility $1349.32 |
| Rest Of New Jersey | Office Unavailable | Facility $1485.96 |
| Rest Of New York | Office Unavailable | Facility $1320.10 |
| Rest Of Oregon | Office Unavailable | Facility $1335.29 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1361.58 |
| Rest Of Texas | Office Unavailable | Facility $1362.79 |
| Rest Of Washington | Office Unavailable | Facility $1377.71 |
| Rhode Island | Office Unavailable | Facility $1404.42 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1415.98 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1385.32 |
| Salinas | Office Unavailable | Facility $1379.72 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1392.38 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1500.80 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1493.48 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1540.76 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1510.86 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1361.15 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1389.67 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1379.47 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1401.66 |
| Seattle (King Cnty) | Office Unavailable | Facility $1478.88 |
| South Carolina | Office Unavailable | Facility $1343.13 |
| South Dakota** | Office Unavailable | Facility $1257.67 |
| Southern Maine | Office Unavailable | Facility $1318.15 |
| Stockton | Office Unavailable | Facility $1346.94 |
| Suburban Chicago | Office Unavailable | Facility $1581.46 |
| Tennessee | Office Unavailable | Facility $1270.85 |
| Utah | Office Unavailable | Facility $1358.74 |
| Vallejo | Office Unavailable | Facility $1443.05 |
| Vermont | Office Unavailable | Facility $1290.94 |
| Virgin Islands | Office Unavailable | Facility $1400.91 |
| Virginia | Office Unavailable | Facility $1331.64 |
| Visalia | Office Unavailable | Facility $1346.94 |
| West Virginia | Office Unavailable | Facility $1449.93 |
| Wisconsin | Office Unavailable | Facility $1237.78 |
| Wyoming** | Office Unavailable | Facility $1344.57 |
| Yuba City | Office Unavailable | Facility $1346.94 |
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43310 billing questions
How does 43310 differ from 43300?
43310 is for repair through a thoracic approach; 43300 is the corresponding repair through a cervical approach. The operative report must support the route used.
When should 43312 be used instead?
Use 43312 when the thoracic esophageal operation also repairs a tracheoesophageal fistula. 43310 describes thoracic repair without that fistula repair.
What documentation supports 43310?
The operative report should identify the esophageal defect, describe the repair, document the thoracic approach, and clarify whether a tracheoesophageal fistula was repaired.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this single esophageal repair.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
What postoperative care is included?
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,21743300,,Repair of esophagus,A,,9.10,6.10,NA,6.10,,1.32,16.52,16.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21843305,,Repair esophagus and fistula,A,,17.65,8.02,NA,8.02,,2.58,28.25,28.25,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,2194330F,,Cnslng epi spec sfty issues,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22043310,,Repair of esophagus,A,,25.60,9.89,NA,9.89,,6.44,41.93,41.93,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22143312,,Repair esophagus and fistula,A,,28.52,8.55,NA,8.55,,7.20,44.27,44.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22243313,,Esophagoplasty congenital,A,,47.24,21.21,NA,21.21,,12.66,81.11,81.11,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22343314,,Tracheo-esophagoplasty cong,A,,52.09,19.92,NA,19.92,,13.96,85.97,85.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00