No office rate
Choose 43400 for ligation of esophageal veins. Choose 43405 when the operation ligates or staples and transects the esophagus.
On this page
CMS RVU26D · Effective 2026-10-01
43405 Esophageal transection Medicare reimbursement rates in Florida
Report this code for operative division of the esophagus using ligation or stapling, such as transection performed during surgical treatment of esophageal varices. Compare 43405 office and facility rates across CMS payment localities in Florida.
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 43405 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1486.81–$1728.32
3 of 3 localities have a supported rate.
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.
Where 43405 pays more and less in Florida
Esophageal surgery
About 43405: Esophageal transection by ligation or stapling
Report this code for operative division of the esophagus using ligation or stapling, such as transection performed during surgical treatment of esophageal varices.
This code represents an operation that interrupts the esophagus by ligating or stapling it and dividing the organ. It may be used in surgical management of esophageal varices, where transection is performed as part of an operative strategy to control bleeding. A surgeon performs the procedure in an operating room, generally in a facility setting; Medicare recorded facility services for this code in 2024 and no office services.
Report the code when the operative documentation supports esophageal ligation or stapling with transection, rather than direct ligation of esophageal veins or repair of an injury. It has 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, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 43405
- 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 RVU24.11 · 57%
- Practice expense (office) RVU11.80 · 28%
- Malpractice RVU6.07 · 14%
27
Medicare services in 2024 · #5739 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.
43405 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
43410 describes repair of an esophageal wound through a cervical approach; 43405 describes ligation or stapling with esophageal transection.
No office rate
43415 describes repair of an esophageal wound through a thoracic or abdominal approach. It is not the code for deliberate esophageal transection.
Compare 43405 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$1571.11
Miami →
Office / nonfacility
Unavailable
Facility
$1728.32
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$1486.81
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43405 billing questions
How does this differ from 43400?
This code describes ligation or stapling with division of the esophagus. Code 43400 is for ligation of esophageal veins, without the esophageal transection described here.
Can this be reported with direct ligation of esophageal veins?
The procedures may be performed during the same operative session for variceal disease. Documentation should identify the distinct esophageal transection and the separate vein-ligation work.
Which global services are included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Medicare may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
How are other procedures in the same session paid?
Medicare pays the highest-valued procedure in full and reduces the other procedures to 50% when multiple procedures are performed in the same session.
What operative documentation supports this code?
The operative report should establish that the esophagus was ligated or stapled and transected. A report describing only vein ligation or repair of an esophageal wound points to a different service.
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.
5,24143360,,Gastrointestinal repair,A,,39.11,14.54,NA,14.54,,9.87,63.52,63.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24243361,,Gastrointestinal repair,A,,44.54,18.60,NA,18.60,,11.94,75.08,75.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24343400,,Ligate esophagus veins,A,,24.96,10.89,NA,10.89,,6.67,42.52,42.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24443405,,Ligate/staple esophagus,A,,24.11,11.80,NA,11.80,,6.07,41.98,41.98,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,2454340F,,Cnslng chldbrng women epi,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24643410,,Repair esophagus wound,A,,16.00,8.67,NA,8.67,,2.34,27.01,27.01,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24743415,,Repair esophagus wound,A,,43.76,17.52,NA,17.52,,11.01,72.29,72.29,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00