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Billing code 43352: EsophagotomyMedicare rate & RVUs

Reports an operative thoracic opening of the esophagus, commonly to reach and remove an obstructing foreign body through a chest approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities37 Medicare services in 2024

Medicare pays $1,034.09 for 43352 nationally in a facility.

Medicare rate · 43352

Esophagotomy

Swap in your local Medicare rate.

Work RVUs
17.36
Total RVUs
30.96
Global days
090

National rate · 2026

$1,034.09

Facility setting, before claim adjustments.

See every locality for 43352 → · 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 43352 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 43352 covers

This service involves opening the esophagus through a thoracic operative approach to access its lumen, commonly for removal of a foreign body. A surgeon performs it in an operating room, typically when endoscopic retrieval is unsuitable or unsuccessful, or when the clinical situation requires direct operative access. The operative report should establish the thoracic approach and describe the esophageal incision and the work performed through it.

Report 43352 for the thoracic esophagotomy rather than a code for esophageal repair or reconstruction. The code has 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, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this service. 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 43352 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

43352 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$932.31
Alaska*Unavailable$1,278.69
ArizonaUnavailable$1,003.55
ArkansasUnavailable$919.95
AtlantaUnavailable$1,070.04
AustinUnavailable$1,036.55
BakersfieldUnavailable$1,017.80
Baltimore/Surr. CntysUnavailable$1,100.41
BeaumontUnavailable$995.98
BrazoriaUnavailable$1,003.91

43352 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
43352 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 43352 rate is calculated

Each of 43352’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 · 43352

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.36Practice expense 9.24Malpractice 4.36

30.9600 adjusted RVUs×$33.4009 conversion factor=$1,034.09

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

Payment rules and modifiers for 43352

43352 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 43352

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 · 43352

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

43352 without 51 · national facility

$1,034.09

Esophagotomy

43352-51 · Second procedure: 50%

$517.05

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

43352 compared with similar codes

Compare codes

43352 vs 43351 vs 43300 vs 43310: national Medicare rates

Swap in your local Medicare rate.

  • 43352
    Esophagotomy · 17.36 wRVU
    —
  • 43351
    Esophagotomy · 21.5 wRVU
    —
  • 43300
    Esophageal repair · 9.1 wRVU
    —
  • 43310
    Esophageal repair · 25.6 wRVU
    —

How to choose

43351Esophagotomy
Both codes describe esophagotomy services. Use the code matching the operative approach documented in the full descriptor; 43352 represents the thoracic approach.
43300Esophageal repair
43300 is an esophageal repair service. Choose it when the operative work is repair, not the thoracic esophageal opening reported with 43352.
43310Esophageal repair
43310 describes another esophageal repair service. The operative objective distinguishes it from the esophagotomy represented by 43352.

Codes related to 43352

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

Codes related to 43352
CodeHow it relatesNational office range
Same family
43351EsophagotomyAdjacent esophagotomy code; distinguish the service by the operative approach in the full descriptor.No office rate
Used instead
43300Esophageal repairEsophageal repair rather than an operative opening to access the esophageal lumen.No office rate
43310Esophageal repairAnother esophageal repair service; report when repair, rather than esophagotomy, is performed.No office rate

43352 billing questions

How is 43352 distinguished from 43351?

These are neighboring esophagotomy codes; select based on the operative approach documented in the full code descriptors. The operative report should make clear that the esophagus was opened through a thoracic approach for 43352.

When should a repair code be used instead?

Use an esophageal repair code when the procedure repairs an esophageal defect or injury rather than performing the thoracic esophagotomy represented by 43352. The operative report should support the actual work performed.

Is modifier 50 appropriate?

No. CMS identifies bilateral adjustment as inappropriate for this service.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

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.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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 43352PPRRVU2026_Oct_nonQPP.csv, line 5,240 (RVU26D)

Open CMS sourceHow we calculate rates

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