Billing code 43124: EsophagectomyMedicare rate & RVUs in Guam
Reports extensive esophageal removal through a thoracotomy, with associated reconstruction, for conditions requiring total or near-total resection.
CMS doesn’t publish an office rate for 43124 in Guam.
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 43124 covers
This code represents a major operation removing most or all of the esophagus through a chest incision, with the associated gastric resection and reconstruction specified for this procedure. It is typically performed by a thoracic or upper gastrointestinal surgeon in a hospital operating room. Common clinical contexts include esophageal cancer and selected severe benign disease when a limited resection is not appropriate. The operative report should establish the extent of esophageal removal, thoracic approach, stomach resection, and reconstruction performed.
Select this code from the operation actually documented, rather than from the diagnosis alone; distinguish it from partial esophagectomy and from total or near-total resections using a different approach or reconstruction. The procedure has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% multiple-procedure reduction. 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.
43124 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $3,415.65 |
How the 43124 rate is calculated
Each of 43124’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 · 43124
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 67.36Practice expense 22.05Malpractice 16.98
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43124
43124 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43124
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 · 43124
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
43124 without 51 · national facility
$3,553.52
Esophagectomy
43124-51 · Second procedure: 50%
$1,776.76
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%).
43124 compared with similar codes
Compare codes
43124 vs 43107 vs 43117 vs 43112 vs 43100: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43107Esophagectomy
- This code involves a thoracotomy. Code 43107 describes total or near-total esophageal removal without a thoracotomy.
- 43117Partial esophagectomy
- Code 43117 is for partial esophageal removal. Choose this code when the operative report supports total or near-total resection through a thoracotomy.
- 43112Esophagectomy
- Both codes are in the total or near-total esophagectomy family. Check the operative report's reconstruction details and the code-specific configuration before choosing between them.
- 43100Esophageal excision
- Code 43100 addresses excision of an esophageal lesion, not removal of most or all of the esophagus.
43124 billing questions
How is this code distinguished from a partial esophagectomy?
Use this code when the documented operation removes most or all of the esophagus. A partial esophagectomy code is appropriate when the surgeon removes only a portion.
What operative details support reporting this code?
The report should document the extent of esophageal removal, the thoracotomy, any proximal stomach resection, and the reconstruction. The diagnosis alone does not establish the procedure performed.
Is related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are reduced to 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while 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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