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Billing code 43340: Esophageal reconstructionMedicare rate & RVUs

Reports surgical reconstruction that connects the esophagus to intestine, commonly when the stomach cannot serve as the route for restoring digestive continuity.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,292.28 for 43340 nationally in a facility.

Medicare rate · 43340

Esophageal reconstruction

Swap in your local Medicare rate.

Work RVUs
22.42
Total RVUs
38.69
Global days
090

National rate · 2026

$1,292.28

Facility setting, before claim adjustments.

See every locality for 43340 → · 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 43340 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 43340 covers

The surgeon creates a connection between the esophagus and intestine to restore passage of swallowed food. This reconstruction may be needed after esophageal or gastric resection when the stomach is unavailable or unsuitable as the receiving organ; a small-intestinal segment, commonly jejunum, may provide the connection. It is performed by a surgeon in an operative setting, rather than as an endoscopic repair or diagnostic procedure.

Report the code when the operative record supports an esophagus-to-intestine reconstruction, distinguishing it from a connection to the stomach and from revision of an existing connection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate 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 43340 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

43340 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,162.43
Alaska*Unavailable$1,599.02
ArizonaUnavailable$1,252.79
ArkansasUnavailable$1,146.72
AtlantaUnavailable$1,340.30
AustinUnavailable$1,290.83
BakersfieldUnavailable$1,261.08
Baltimore/Surr. CntysUnavailable$1,376.80
BeaumontUnavailable$1,247.18
BrazoriaUnavailable$1,251.10

43340 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
43340 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 43340 rate is calculated

Each of 43340’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 · 43340

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.42Practice expense 10.27Malpractice 6.00

38.6900 adjusted RVUs×$33.4009 conversion factor=$1,292.28

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

Payment rules and modifiers for 43340

43340 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43340

Esophageal reconstruction

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 · 43340

Esophageal reconstruction

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

43340 without 51 · national facility

$1,292.28

Esophageal reconstruction

43340-51 · Second procedure: 50%

$646.14

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

43340 compared with similar codes

Compare codes

43340 vs 43320 vs 43341 vs 43325: national Medicare rates

Swap in your local Medicare rate.

  • 43340
    Esophageal reconstruction · 22.42 wRVU
    —
  • 43320
    Esophageal reconstruction · 22.73 wRVU
    —
  • 43341
    Esophageal anastomosis · 23.62 wRVU
    —
  • 43325
    Anastomosis revision · 22.04 wRVU
    —

How to choose

43320Esophageal reconstruction
Use 43340 when the esophagus is joined to intestine; use 43320 when the receiving organ is the stomach.
43341Esophageal anastomosis
This is a related esophagus-to-intestine reconstruction code. Choose between the codes by matching the operative circumstances to each code's descriptor.
43325Anastomosis revision
43325 concerns revision of an esophagus-to-stomach connection. It is not the code for creating a new esophagus-to-intestine connection.

Codes related to 43340

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

Codes related to 43340
CodeHow it relatesNational office range
Used instead
43320Esophageal reconstructionConnects the esophagus to the stomach rather than to intestine.No office rate
Same family
43341Esophageal anastomosisRelated esophagus-to-intestine reconstruction code; select according to its distinct descriptor.No office rate
43325Anastomosis revisionAddresses revision involving an esophagus-to-stomach connection, not creation of this intestinal connection.No office rate

43340 billing questions

How is this distinguished from 43320?

This code describes a connection from the esophagus to intestine. 43320 is for a connection to the stomach, so the receiving organ documented in the operative report is the key distinction.

What documentation supports reporting it?

The operative report should identify the esophagus and intestinal segment joined and describe creation of the reconstruction. A note describing only esophageal repair or revision of an existing connection does not establish this service.

Can modifier 50 be reported?

No. Modifier 50 is not appropriate for this esophagus-to-intestine reconstruction.

How does the global period affect postoperative care?

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 available. Co-surgeon payment requires supporting documentation, while team surgery is not permitted for this code.

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 43340PPRRVU2026_Oct_nonQPP.csv, line 5,237 (RVU26D)

Open CMS sourceHow we calculate rates

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