Billing code 43100: Esophageal excisionMedicare rate & RVUs in Alaska
Reports open removal of a localized lesion from the cervical esophagus through a neck approach, rather than endoscopic treatment or esophageal resection.
CMS doesn’t publish an office rate for 43100 in Alaska.
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 9 sections
What 43100 covers
Code 43100 describes an open operation to remove a localized lesion from the cervical portion of the esophagus through a neck incision. A surgeon, commonly an otolaryngologist or thoracic surgeon, exposes the esophagus, excises the lesion, and addresses the esophageal opening. The service is typically performed in a hospital operating room; it is not a code for endoscopic biopsy or transoral lesion removal.
Select this code when the operative report supports local excision using a cervical approach. Document the lesion, its esophageal location, the surgical approach, and whether the surgeon removed a focal lesion or resected an esophageal segment. The 90-day global 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 reduction. Modifier 50 is inappropriate. 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.
43100 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $707.93 |
How the 43100 rate is calculated
Each of 43100’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 · 43100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.42Practice expense 5.93Malpractice 1.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43100
43100 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43100
Esophageal excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43100
Esophageal excision
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43100 without 51 · national facility
$558.13
Esophageal excision
43100-51 · Second procedure: 50%
$279.07
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%).
43100 compared with similar codes
Compare codes
43100 vs 43101 vs 43180 vs 43116: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43101Esophageal lesion excision
- This is the neighboring open lesion-excision code for a different surgical approach. Choose between 43100 and 43101 from the approach documented in the operative report.
- 43180Diverticulotomy
- 43180 describes rigid transoral endoscopic lesion excision; 43100 describes open excision through a cervical approach.
- 43116Esophagectomy
- 43116 is for partial esophageal removal. Use 43100 for local lesion excision when the operation does not remove an esophageal segment.
43100 billing questions
How is 43100 distinguished from 43101?
Both describe open excision of an esophageal lesion, but 43100 is for a cervical approach. Use 43101 when the documented approach is the one specified by that code.
Can 43100 be used for endoscopic lesion removal?
No. It represents open excision through a cervical approach. Rigid transoral endoscopic lesion excision is represented by 43180.
When is a partial esophagectomy code more appropriate?
Use a partial esophagectomy code when the surgeon removes an esophageal segment rather than locally excising a lesion. The operative report should make the extent of removal clear.
Can modifier 50 be appended?
No. The CMS bilateral adjustment does not apply to 43100, and modifier 50 is inappropriate for this service.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
How are assistant and co-surgeon claims handled?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is submitted; 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
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