Billing code 43108: EsophagectomyMedicare rate & RVUs in Delaware
Reports removal of nearly all or all of the esophagus without thoracotomy when reconstruction uses a colon segment or another substitute conduit.
CMS doesn’t publish an office rate for 43108 in Delaware.
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 43108 covers
This operation removes nearly all or all of the esophagus through an approach that does not use a thoracotomy, then restores continuity with a colon segment or another substitute conduit. It is typically performed by a thoracic or general surgeon in an operating room for conditions requiring extensive esophageal removal, such as esophageal cancer or severe benign disease. The operative report should establish the extent of removal, the approach, and the reconstructive conduit used.
The reconstruction is part of the reported service; distinguish this code from a similar operation using the stomach for reconstruction and from esophagectomy performed with thoracotomy. Medicare assigns 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, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
43108 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $4,035.76 |
How the 43108 rate is calculated
Each of 43108’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 · 43108
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 80.80Practice expense 21.57Malpractice 20.37
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43108
43108 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43108
Esophagectomy
| 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 · 43108
Esophagectomy
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
43108 without 51 · national facility
$4,099.63
Esophagectomy
43108-51 · Second procedure: 50%
$2,049.82
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%).
43108 compared with similar codes
Compare codes
43108 vs 43107 vs 43113 vs 43112 vs 43116: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43107Esophagectomy
- Both use an approach without thoracotomy for extensive esophageal removal. The distinguishing factor is reconstruction: 43108 uses a substitute conduit, while 43107 uses the stomach.
- 43113Esophagectomy
- Both involve extensive removal with substitute-conduit reconstruction. Report 43113 when thoracotomy is used; 43108 describes the operation without thoracotomy.
- 43112Esophagectomy
- 43112 describes extensive removal with thoracotomy and stomach-based reconstruction. This code describes no thoracotomy and reconstruction with a substitute conduit.
- 43116Esophagectomy
- 43116 is a partial-removal option. This code is for removal of nearly all or all of the esophagus with substitute-conduit reconstruction.
43108 billing questions
How does this differ from 43107?
Both describe extensive esophageal removal without thoracotomy. Choose 43108 when reconstruction uses a colon segment or another substitute conduit; 43107 describes reconstruction using the stomach.
Is the conduit reconstruction separately reported?
The substitute-conduit reconstruction is included in this esophagectomy service. The operative documentation should identify the conduit used.
When is 43113 a better match?
43113 describes the corresponding extensive removal and substitute-conduit reconstruction when the operation includes thoracotomy. This code is for the approach without thoracotomy.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What payment rules apply when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. The service has a 90-day global period; assistant-at-surgery payment may be made, co-surgeons require supporting documentation, and 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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