No office rate
Choose 43331 for the thoracic route and 43330 for the abdominal route; the access approach, not the diagnosis, distinguishes them.
On this page
CMS RVU26D · Effective 2026-10-01
43331 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1241.12
Base rate per service
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.
Esophageal surgery
About 43331: Thoracic approach esophageal myotomy
Reports a thoracic approach to esophageal muscle division, commonly for achalasia, with fundoplasty included when performed during the operation.
This operation divides the esophageal muscle through a thoracic approach to relieve impaired passage, most commonly in a patient with achalasia. A thoracic or general surgeon typically performs it in a hospital operating room. The surgeon may add a fundoplasty during the same operation; that option is encompassed by this service rather than treated as a separate fundoplasty procedure.
Select this code based on the thoracic route and the operative work, not on disease severity. The operative report should identify the approach, the myotomy performed, and any fundoplasty. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this single esophageal operation. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43331
- 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 RVU22.48 · 59%
- Practice expense (office) RVU10.25 · 27%
- Malpractice RVU5.66 · 15%
14
Medicare services in 2024 · #6102 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.
43331 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
This code represents a laparoscopic Heller-type myotomy. Use 43331 when the documented operation uses a thoracic approach.
43499
No office rateUnlisted procedure esophagus
This is an unlisted esophageal procedure code that may be used for POEM. It is not the code for a thoracic surgical myotomy.
The same code, a different location
How does El Centro compare?
43331 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Modesto
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Napa
California · 43331
Office
Unavailable
Facility
$1345.42
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43331
Office
Unavailable
Facility
$1294.32
No comparable office rate is available.
Redding
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Rest Of California
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43331
Office
Unavailable
Facility
$1300.85
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43331
Office
Unavailable
Facility
$1277.38
No comparable office rate is available.
Salinas
California · 43331
Office
Unavailable
Facility
$1272.25
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43331
Office
Unavailable
Facility
$1285.30
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43331
Office
Unavailable
Facility
$1391.68
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43331
Office
Unavailable
Facility
$1385.26
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43331
Office
Unavailable
Facility
$1428.46
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43331
Office
Unavailable
Facility
$1402.18
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43331
Office
Unavailable
Facility
$1254.89
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43331
Office
Unavailable
Facility
$1283.92
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43331
Office
Unavailable
Facility
$1272.40
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43331
Office
Unavailable
Facility
$1295.13
No comparable office rate is available.
Stockton
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Vallejo
California · 43331
Office
Unavailable
Facility
$1336.16
No comparable office rate is available.
Visalia
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Yuba City
California · 43331
Office
Unavailable
Facility
$1240.17
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 43331
Office
Unavailable
Facility
$1405.11
No comparable office rate is available.
Miami
Florida · 43331
Office
Unavailable
Facility
$1585.35
No comparable office rate is available.
Chicago
Illinois · 43331
Office
Unavailable
Facility
$1534.05
No comparable office rate is available.
Manhattan
New York · 43331
Office
Unavailable
Facility
$1496.56
No comparable office rate is available.
Alaska*
Alaska · 43331
Office
Unavailable
Facility
$1595.06
No comparable office rate is available.
Alabama
Alabama · 43331
Office
Unavailable
Facility
$1157.42
No comparable office rate is available.
Arkansas
Arkansas · 43331
Office
Unavailable
Facility
$1142.30
No comparable office rate is available.
Arizona
Arizona · 43331
Office
Unavailable
Facility
$1244.42
No comparable office rate is available.
Colorado
Colorado · 43331
Office
Unavailable
Facility
$1271.78
No comparable office rate is available.
Connecticut
Connecticut · 43331
Office
Unavailable
Facility
$1363.34
No comparable office rate is available.
Delaware
Delaware · 43331
Office
Unavailable
Facility
$1262.81
No comparable office rate is available.
Fort Lauderdale
Florida · 43331
Office
Unavailable
Facility
$1439.46
No comparable office rate is available.
Rest Of Florida
Florida · 43331
Office
Unavailable
Facility
$1362.29
No comparable office rate is available.
Atlanta
Georgia · 43331
Office
Unavailable
Facility
$1327.99
No comparable office rate is available.
Rest Of Georgia
Georgia · 43331
Office
Unavailable
Facility
$1281.58
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43331
Office
Unavailable
Facility
$1249.57
No comparable office rate is available.
Iowa
Iowa · 43331
Office
Unavailable
Facility
$1139.16
No comparable office rate is available.
Idaho
Idaho · 43331
Office
Unavailable
Facility
$1155.24
No comparable office rate is available.
East St. Louis
Illinois · 43331
Office
Unavailable
Facility
$1446.57
No comparable office rate is available.
Rest Of Illinois
Illinois · 43331
Office
Unavailable
Facility
$1358.91
No comparable office rate is available.
Suburban Chicago
Illinois · 43331
Office
Unavailable
Facility
$1442.71
No comparable office rate is available.
Indiana
Indiana · 43331
Office
Unavailable
Facility
$1160.10
No comparable office rate is available.
Kansas
Kansas · 43331
Office
Unavailable
Facility
$1155.63
No comparable office rate is available.
Kentucky
Kentucky · 43331
Office
Unavailable
Facility
$1228.19
No comparable office rate is available.
New Orleans
Louisiana · 43331
Office
Unavailable
Facility
$1287.77
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43331
Office
Unavailable
Facility
$1234.95
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43331
Office
Unavailable
Facility
$1358.67
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43331
Office
Unavailable
Facility
$1274.04
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43331
Office
Unavailable
Facility
$1364.07
No comparable office rate is available.
Rest Of Maryland
Maryland · 43331
Office
Unavailable
Facility
$1278.38
No comparable office rate is available.
Rest Of Maine
Maine · 43331
Office
Unavailable
Facility
$1183.41
No comparable office rate is available.
Southern Maine
Maine · 43331
Office
Unavailable
Facility
$1209.42
No comparable office rate is available.
Detroit
Michigan · 43331
Office
Unavailable
Facility
$1399.97
No comparable office rate is available.
Rest Of Michigan
Michigan · 43331
Office
Unavailable
Facility
$1276.86
No comparable office rate is available.
Minnesota
Minnesota · 43331
Office
Unavailable
Facility
$1159.10
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43331
Office
Unavailable
Facility
$1257.03
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43331
Office
Unavailable
Facility
$1266.21
No comparable office rate is available.
Rest Of Missouri
Missouri · 43331
Office
Unavailable
Facility
$1230.10
No comparable office rate is available.
Mississippi
Mississippi · 43331
Office
Unavailable
Facility
$1185.33
No comparable office rate is available.
Montana**
Montana · 43331
Office
Unavailable
Facility
$1281.88
No comparable office rate is available.
North Carolina
North Carolina · 43331
Office
Unavailable
Facility
$1191.08
No comparable office rate is available.
North Dakota**
North Dakota · 43331
Office
Unavailable
Facility
$1169.97
No comparable office rate is available.
Nebraska
Nebraska · 43331
Office
Unavailable
Facility
$1138.31
No comparable office rate is available.
New Hampshire
New Hampshire · 43331
Office
Unavailable
Facility
$1272.67
No comparable office rate is available.
Northern Nj
New Jersey · 43331
Office
Unavailable
Facility
$1397.20
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43331
Office
Unavailable
Facility
$1362.13
No comparable office rate is available.
New Mexico
New Mexico · 43331
Office
Unavailable
Facility
$1291.84
No comparable office rate is available.
Nevada**
Nevada · 43331
Office
Unavailable
Facility
$1251.03
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43331
Office
Unavailable
Facility
$1557.04
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43331
Office
Unavailable
Facility
$1388.27
No comparable office rate is available.
Queens
New York · 43331
Office
Unavailable
Facility
$1476.18
No comparable office rate is available.
Rest Of New York
New York · 43331
Office
Unavailable
Facility
$1209.00
No comparable office rate is available.
Ohio
Ohio · 43331
Office
Unavailable
Facility
$1253.99
No comparable office rate is available.
Oklahoma
Oklahoma · 43331
Office
Unavailable
Facility
$1203.47
No comparable office rate is available.
Portland
Oregon · 43331
Office
Unavailable
Facility
$1283.88
No comparable office rate is available.
Rest Of Oregon
Oregon · 43331
Office
Unavailable
Facility
$1224.74
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43331
Office
Unavailable
Facility
$1346.30
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43331
Office
Unavailable
Facility
$1243.79
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43331
Office
Unavailable
Facility
$1283.19
No comparable office rate is available.
Rhode Island
Rhode Island · 43331
Office
Unavailable
Facility
$1287.41
No comparable office rate is available.
South Carolina
South Carolina · 43331
Office
Unavailable
Facility
$1227.88
No comparable office rate is available.
South Dakota**
South Dakota · 43331
Office
Unavailable
Facility
$1156.73
No comparable office rate is available.
Tennessee
Tennessee · 43331
Office
Unavailable
Facility
$1163.58
No comparable office rate is available.
Austin
Texas · 43331
Office
Unavailable
Facility
$1282.07
No comparable office rate is available.
Beaumont
Texas · 43331
Office
Unavailable
Facility
$1238.03
No comparable office rate is available.
Brazoria
Texas · 43331
Office
Unavailable
Facility
$1243.60
No comparable office rate is available.
Dallas
Texas · 43331
Office
Unavailable
Facility
$1260.80
No comparable office rate is available.
Fort Worth
Texas · 43331
Office
Unavailable
Facility
$1259.84
No comparable office rate is available.
Galveston
Texas · 43331
Office
Unavailable
Facility
$1253.35
No comparable office rate is available.
Houston
Texas · 43331
Office
Unavailable
Facility
$1356.95
No comparable office rate is available.
Rest Of Texas
Texas · 43331
Office
Unavailable
Facility
$1246.46
No comparable office rate is available.
Utah
Utah · 43331
Office
Unavailable
Facility
$1242.44
No comparable office rate is available.
Virginia
Virginia · 43331
Office
Unavailable
Facility
$1220.86
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43331
Office
Unavailable
Facility
$1283.19
No comparable office rate is available.
Vermont
Vermont · 43331
Office
Unavailable
Facility
$1185.45
No comparable office rate is available.
Rest Of Washington
Washington · 43331
Office
Unavailable
Facility
$1264.98
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43331
Office
Unavailable
Facility
$1362.92
No comparable office rate is available.
Wisconsin
Wisconsin · 43331
Office
Unavailable
Facility
$1137.06
No comparable office rate is available.
West Virginia
West Virginia · 43331
Office
Unavailable
Facility
$1318.89
No comparable office rate is available.
Wyoming**
Wyoming · 43331
Office
Unavailable
Facility
$1233.11
No comparable office rate is available.
See how rates vary across the country
43331 · 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 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 43331 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1365.23
$1241.12 × 110% = $1365.23
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43331 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
5,229
- Code
- 43331
- Physician work
- 22.48
- Practice expense
- 10.25
- Malpractice
- 5.66
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.48 | × 1.017 | 22.8622 |
| Practice expense | 10.25 | × 1.096 | 11.2340 |
| Malpractice | 5.66 | × 0.541 | 3.0621 |
| Total RVUs | 37.1582 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$1241.12
Open 43331 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.48 | 1.017 |
| Practice expense | 10.25 | 1.096 |
| Malpractice | 5.66 | 0.541 |
(22.48 × 1.017 + 10.25 × 1.096 + 5.66 × 0.541) × $33.4009 = $1241.12
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
43331 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1241.12 | RVU26D |
| 2026-07-01 | Not available in this setting | $1241.12 | RVU26C |
| 2026-04-01 | Not available in this setting | $1241.12 | RVU26B |
| 2026-01-01 | Not available in this setting | $1241.12 | RVU26A |
| 2025-10-01 | Not available in this setting | $1257.56 | RVU25D |
| 2025-07-01 | Not available in this setting | $1257.56 | RVU25C |
| 2025-04-01 | Not available in this setting | $1257.56 | RVU25B |
| 2025-01-01 | Not available in this setting | $1257.56 | RVU25A |
43331 billing questions
How does this differ from 43330?
The operative route determines the choice: 43331 is for a thoracic approach, while 43330 is for an abdominal approach.
Can a fundoplasty be billed separately with this code?
A fundoplasty performed as part of the myotomy is included in this service. The operative report should describe it when performed.
Should modifier 50 be reported?
No. Modifier 50 is not appropriate for this operation on the esophagus.
What documentation supports the thoracic approach?
The operative report should establish the thoracic route and describe the esophageal muscle division, along with any fundoplasty performed.
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 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.
5,22643327,,Esoph fundoplasty lap,A,,13.02,7.20,NA,7.20,,3.47,23.69,23.69,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22743328,,Esoph fundoplasty thor,A,,19.41,7.48,NA,7.48,,4.88,31.77,31.77,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22843330,,Esophagomyotomy abdominal,A,,21.64,10.08,NA,10.08,,5.77,37.49,37.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,22943331,,Esophagomyotomy thoracic,A,,22.48,10.25,NA,10.25,,5.66,38.39,38.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23043332,,Transab esoph hiat hern rpr,A,,19.13,8.26,NA,8.26,,4.88,32.27,32.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23143333,,Transab esoph hiat hern rpr,A,,20.92,8.87,NA,8.87,,5.41,35.20,35.20,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23243334,,Transthor diaphrag hern rpr,A,,21.57,7.91,NA,7.91,,5.45,34.93,34.93,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664