No office rate
43327 reports laparoscopic esophagogastric fundoplasty. Use 43338 only when the surgeon also performs an esophageal lengthening procedure.
On this page
CMS RVU26D · Effective 2026-10-01
43338 Esophageal lengthening Medicare reimbursement rates in Colorado
Reports surgical lengthening of a shortened esophagus, such as Collis gastroplasty, performed as an adjunct during an esophageal or hiatal hernia operation. Compare 43338 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 43338 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$101.43
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Esophageal surgery
About 43338: Esophageal lengthening procedure
Reports surgical lengthening of a shortened esophagus, such as Collis gastroplasty, performed as an adjunct during an esophageal or hiatal hernia operation.
This add-on describes an operation that lengthens the esophagus, commonly by creating a tubular extension from the stomach in a Collis gastroplasty. A surgeon may perform it when a short esophagus prevents adequate positioning below the diaphragm during repair of a paraesophageal or hiatal hernia. It is an operative service, not routine mobilization of the esophagus or a standalone diagnostic procedure.
Report 43338 only with the primary operation for which the lengthening was performed; it is not billed by itself. The operative report should identify the short esophagus, the lengthening technique, and the associated primary procedure. CMS classifies this as an add-on code, paid within the primary procedure's global period. The add-on payment is therefore handled as part of that primary procedure's global surgical episode.
CMS billing rules for 43338
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU2.15 · 69%
- Practice expense (office) RVU0.42 · 14%
- Malpractice RVU0.53 · 17%
28
Medicare services in 2024 · #5707 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.
43338 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
43328 reports thoracic esophagogastric fundoplasty; it does not by itself describe lengthening a short esophagus.
No office rate
43313 concerns congenital esophageal reconstruction, whereas 43338 describes an adjunctive lengthening procedure such as Collis gastroplasty.
Compare 43338 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$101.43
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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 43338 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
5,236
- Code
- 43338
- Physician work
- 2.15
- Practice expense
- 0.42
- Malpractice
- 0.53
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.15 | × 1.012 | 2.1758 |
| Practice expense | 0.42 | × 1.064 | 0.4469 |
| Malpractice | 0.53 | × 0.781 | 0.4139 |
| Total RVUs | 3.0366 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$101.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1.012 |
| Practice expense | 0.42 | 1.064 |
| Malpractice | 0.53 | 0.781 |
(2.15 × 1.012 + 0.42 × 1.064 + 0.53 × 0.781) × $33.4009 = $101.43
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.
43338 billing questions
When is esophageal lengthening separately reported?
Report 43338 when the surgeon performs a distinct lengthening procedure, such as a Collis gastroplasty, in addition to the primary operation. Routine esophageal mobilization alone does not describe this service.
Can 43338 be billed by itself?
No. CMS identifies 43338 as an add-on code that must be billed with a primary procedure.
What documentation supports 43338?
The operative report should describe the short esophagus, the lengthening performed, and the primary operation performed during the same surgical episode.
Is a fundoplication alone enough to report 43338?
No. A fundoplication does not establish that esophageal lengthening was performed. The record must document the additional lengthening procedure.
How does the global period affect payment?
CMS pays 43338 within the global period of its primary procedure. It is not treated as a separate standalone surgical episode.
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.
5,23343335,,Transthor diaphrag hern rpr,A,,23.37,8.26,NA,8.26,,5.88,37.51,37.51,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23443336,,Thorabd diaphr hern repair,A,,25.16,9.34,NA,9.34,,6.34,40.84,40.84,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23543337,,Thorabd diaphr hern repair,A,,26.96,9.70,NA,9.70,,6.78,43.44,43.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23643338,,Esoph lengthening,A,,2.15,0.42,NA,0.42,,0.53,3.10,3.10,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23743340,,Fuse esophagus & intestine,A,,22.42,10.27,NA,10.27,,6.00,38.69,38.69,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23843341,,Fuse esophagus & intestine,A,,23.62,10.47,NA,10.47,,5.96,40.05,40.05,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23943351,,Surgical opening esophagus,A,,21.50,11.28,NA,11.28,,5.41,38.19,38.19,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899