No office rate
Both are thoracic partial esophagectomy codes. Choose 43118 for reconstruction with colon or small intestine; choose 43117 when the reconstruction is an esophagogastrostomy.
On this page
CMS RVU26D · Effective 2026-10-01
43118 Partial esophagectomy Medicare reimbursement rates in Delaware
Reports partial removal of the esophagus through a thoracic approach when continuity is reconstructed with a colon or small-intestinal segment. Compare 43118 office and facility rates across CMS payment localities in Delaware.
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 43118 in Delaware?
Delaware 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
$3301.98
1 of 1 localities have a supported rate.
Payment area: Delaware
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 43118: Thoracic partial esophagectomy with intestinal reconstruction
Reports partial removal of the esophagus through a thoracic approach when continuity is reconstructed with a colon or small-intestinal segment.
This operation removes part of the esophagus through a thoracic approach and restores continuity using a segment of colon or small intestine rather than the stomach. Thoracic and upper gastrointestinal surgeons typically perform it in a hospital operating room for selected esophageal disease requiring resection and intestinal reconstruction. The operative plan and report identify the resected portion, thoracic route, and reconstructed pathway.
Choose this code when the documented operation matches both the thoracic approach and intestinal conduit reconstruction; a reconstruction using the stomach is represented by a different code. The 90-day global period 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 50% reduction. Assistant-at-surgery and co-surgeon payment may be allowed; team surgery is not permitted. The esophageal operation is not coded as bilateral, so modifier 50 is inappropriate.
CMS billing rules for 43118
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU65.39 · 65%
- Practice expense (office) RVU18.54 · 18%
- Malpractice RVU16.49 · 16%
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.
43118 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both pair partial esophagectomy with intestinal reconstruction, but 43122 is the abdominal-approach code. The documented operative approach distinguishes it from 43118.
No office rate
43107 represents total or near-total esophageal removal with cervical gastric reconstruction. 43118 is for partial removal through a thoracic approach with an intestinal conduit.
Compare 43118 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
Delaware →
Office / nonfacility
Unavailable
Facility
$3301.98
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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 43118 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
5,124
- Code
- 43118
- Physician work
- 65.39
- Practice expense
- 18.54
- Malpractice
- 16.49
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 65.39 | × 1.005 | 65.7169 |
| Practice expense | 18.54 | × 0.988 | 18.3175 |
| Malpractice | 16.49 | × 0.899 | 14.8245 |
| Total RVUs | 98.8590 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$3301.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 65.39 | 1.005 |
| Practice expense | 18.54 | 0.988 |
| Malpractice | 16.49 | 0.899 |
(65.39 × 1.005 + 18.54 × 0.988 + 16.49 × 0.899) × $33.4009 = $3301.98
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.
43118 billing questions
How does 43118 differ from 43117?
Both describe thoracic partial esophagectomy, but 43118 involves reconstruction with colon or small intestine. 43117 is the thoracic partial resection code when reconstruction is by esophagogastrostomy.
When should 43118 be chosen over an abdominal approach code?
Use 43118 when the documented resection is performed through a thoracic approach and reconstruction uses an intestinal segment. An abdominal approach points to a different code in the partial esophagectomy family.
What operative documentation supports 43118?
The report should establish that the esophagectomy was partial, performed through a thoracic approach, and reconstructed with colon or small intestine. It should identify the conduit used and the operative work performed.
How does the 90-day global period affect related care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The surgeon’s related routine care during that period is not separately reported as another service.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and for co-surgeons for this code. 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.
5,12143113,,Removal of esophagus,A,,78.06,22.93,NA,22.93,,19.70,120.69,120.69,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12243116,,Partial removal of esophagus,A,,90.67,23.52,NA,23.52,,22.88,137.07,137.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12343117,,Partial removal of esophagus,A,,56.06,20.48,NA,20.48,,14.13,90.67,90.67,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12443118,,Partial removal of esophagus,A,,65.39,18.54,NA,18.54,,16.49,100.42,100.42,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12543121,,Partial removal of esophagus,A,,50.14,17.40,NA,17.40,,12.66,80.20,80.20,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12643122,,Partial removal of esophagus,A,,43.08,16.00,NA,16.00,,10.87,69.95,69.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12743123,,Partial removal of esophagus,A,,81.04,23.52,NA,23.52,,20.45,125.01,125.01,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503