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Billing code 43351: EsophagotomyMedicare rate & RVUs

Reports open thoracic access to the esophagus to remove a foreign body when surgical extraction, rather than endoscopic retrieval, is performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,275.58 for 43351 nationally in a facility.

Medicare rate · 43351

Esophagotomy

Swap in your local Medicare rate.

Work RVUs
21.5
Total RVUs
38.19
Global days
090

National rate · 2026

$1,275.58

Facility setting, before claim adjustments.

See every locality for 43351 → · 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 43351 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 43351 covers

billing code 43351 describes an open incision into the esophagus through a thoracic approach to remove a foreign body. A thoracic or general surgeon typically performs the operation in a hospital operating room when surgical access is needed to retrieve an object lodged in the esophagus. The surgeon identifies the object through the operative exposure, removes it through the esophageal opening, and closes the incision.

Select this code when the operative report documents thoracic access and removal of a foreign body; the approach distinguishes it from cervical and abdominal esophagotomy codes. The record should identify the object, its location, the surgical approach, and the extraction performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. An assistant may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.

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 43351 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

43351 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,150.06
Alaska*Unavailable$1,578.00
ArizonaUnavailable$1,237.88
ArkansasUnavailable$1,134.82
AtlantaUnavailable$1,320.08
AustinUnavailable$1,278.27
BakersfieldUnavailable$1,254.74
Baltimore/Surr. CntysUnavailable$1,357.40
BeaumontUnavailable$1,228.84
BrazoriaUnavailable$1,238.18

43351 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
43351 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 43351 rate is calculated

Each of 43351’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 · 43351

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.50Practice expense 11.28Malpractice 5.41

38.1900 adjusted RVUs×$33.4009 conversion factor=$1,275.58

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

Payment rules and modifiers for 43351

43351 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43351

Esophagotomy

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 · 43351

Esophagotomy

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

43351 without 51 · national facility

$1,275.58

Esophagotomy

43351-51 · Second procedure: 50%

$637.79

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

43351 compared with similar codes

Compare codes

43351 vs 43352 vs 43215: national Medicare rates

Swap in your local Medicare rate.

  • 43351
    Esophagotomy · 21.5 wRVU
    —
  • 43352
    Esophagotomy · 17.36 wRVU
    —
  • 43215
    Object removal · 2.38 wRVU
    $436.55

How to choose

43352Esophagotomy
Use 43352 for the abdominal approach to esophagotomy and foreign-body removal; 43351 represents the thoracic approach.
43215Object removal
43215 is flexible transoral endoscopic removal. 43351 is open removal through a thoracic esophageal incision.

Codes related to 43351

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

Codes related to 43351
CodeHow it relatesNational office range
Same family
43352EsophagotomyAbdominal approach for esophagotomy and foreign-body removal.No office rate
Used instead
43215Object removalFlexible transoral esophagoscopy for endoscopic foreign-body removal.$382.07–$592.22

43351 billing questions

How is 43351 distinguished from 43350 and 43352?

Choose 43351 when the esophageal incision and foreign-body removal use a thoracic approach. Codes 43350 and 43352 represent cervical and abdominal approaches, respectively.

When would 43215 be reported instead?

43215 describes flexible transoral esophagoscopy with foreign-body removal. Use 43351 for open removal through a thoracic esophageal incision, not endoscopic retrieval.

What documentation supports 43351?

Document the foreign body and its esophageal location, the thoracic operative approach, and the removal through an esophageal incision.

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

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

Can an assistant or co-surgeon be reported?

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

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 43351PPRRVU2026_Oct_nonQPP.csv, line 5,239 (RVU26D)

Open CMS sourceHow we calculate rates

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