Billing code 43340: Esophageal reconstructionMedicare rate & RVUs in Guam
Reports surgical reconstruction that connects the esophagus to intestine, commonly when the stomach cannot serve as the route for restoring digestive continuity.
CMS doesn’t publish an office rate for 43340 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 43340 covers
The surgeon creates a connection between the esophagus and intestine to restore passage of swallowed food. This reconstruction may be needed after esophageal or gastric resection when the stomach is unavailable or unsuitable as the receiving organ; a small-intestinal segment, commonly jejunum, may provide the connection. It is performed by a surgeon in an operative setting, rather than as an endoscopic repair or diagnostic procedure.
Report the code when the operative record supports an esophagus-to-intestine reconstruction, distinguishing it from a connection to the stomach and from revision of an existing connection. 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% multiple-procedure reduction. Modifier 50 is not appropriate for this anatomy. An assistant at surgery may be paid; 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.
43340 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,254.90 |
How the 43340 rate is calculated
Each of 43340’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 · 43340
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 22.42Practice expense 10.27Malpractice 6.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43340
43340 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43340
Esophageal reconstruction
| 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 · 43340
Esophageal reconstruction
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
43340 without 51 · national facility
$1,292.28
Esophageal reconstruction
43340-51 · Second procedure: 50%
$646.14
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%).
43340 compared with similar codes
Compare codes
43340 vs 43320 vs 43341 vs 43325: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43320Esophageal reconstruction
- Use 43340 when the esophagus is joined to intestine; use 43320 when the receiving organ is the stomach.
- 43341Esophageal anastomosis
- This is a related esophagus-to-intestine reconstruction code. Choose between the codes by matching the operative circumstances to each code's descriptor.
- 43325Anastomosis revision
- 43325 concerns revision of an esophagus-to-stomach connection. It is not the code for creating a new esophagus-to-intestine connection.
43340 billing questions
How is this distinguished from 43320?
This code describes a connection from the esophagus to intestine. 43320 is for a connection to the stomach, so the receiving organ documented in the operative report is the key distinction.
What documentation supports reporting it?
The operative report should identify the esophagus and intestinal segment joined and describe creation of the reconstruction. A note describing only esophageal repair or revision of an existing connection does not establish this service.
Can modifier 50 be reported?
No. Modifier 50 is not appropriate for this esophagus-to-intestine reconstruction.
How does the global period affect postoperative care?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while team surgery is not permitted for this code.
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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