No office rate
Use 43340 when the esophagus is joined to intestine; use 43320 when the receiving organ is the stomach.
On this page
CMS RVU26D · Effective 2026-10-01
43340 Esophageal reconstruction Medicare reimbursement rates in Hawaii
Reports surgical reconstruction that connects the esophagus to intestine, commonly when the stomach cannot serve as the route for restoring digestive continuity. Compare 43340 office and facility rates across CMS payment localities in Hawaii.
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 43340 in Hawaii?
Hawaii 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
$1254.90
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Digestive surgery
About 43340: Esophagus-to-intestine reconstruction
Reports surgical reconstruction that connects the esophagus to intestine, commonly when the stomach cannot serve as the route for restoring digestive continuity.
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.
CMS billing rules for 43340
- 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 RVU22.42 · 58%
- Practice expense (office) RVU10.27 · 27%
- Malpractice RVU6.00 · 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.
43340 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This is a related esophagus-to-intestine reconstruction code. Choose between the codes by matching the operative circumstances to each code's descriptor.
No office rate
43325 concerns revision of an esophagus-to-stomach connection. It is not the code for creating a new esophagus-to-intestine connection.
Compare 43340 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1254.90
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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 43340 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,237
- Code
- 43340
- Physician work
- 22.42
- Practice expense
- 10.27
- Malpractice
- 6.00
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.42 | × 1.000 | 22.4200 |
| Practice expense | 10.27 | × 1.137 | 11.6770 |
| Malpractice | 6.00 | × 0.579 | 3.4740 |
| Total RVUs | 37.5710 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1254.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.42 | 1 |
| Practice expense | 10.27 | 1.137 |
| Malpractice | 6 | 0.579 |
(22.42 × 1 + 10.27 × 1.137 + 6 × 0.579) × $33.4009 = $1254.90
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.
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 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.
5,23443336,,Thorabd diaphr hern repair,A,,25.16,9.34,NA,9.34,,6.34,40.84,40.84,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23543337,,Thorabd diaphr hern repair,A,,26.96,9.70,NA,9.70,,6.78,43.44,43.44,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23643338,,Esoph lengthening,A,,2.15,0.42,NA,0.42,,0.53,3.10,3.10,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23743340,,Fuse esophagus & intestine,A,,22.42,10.27,NA,10.27,,6.00,38.69,38.69,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23843341,,Fuse esophagus & intestine,A,,23.62,10.47,NA,10.47,,5.96,40.05,40.05,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,23943351,,Surgical opening esophagus,A,,21.50,11.28,NA,11.28,,5.41,38.19,38.19,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24043352,,Surgical opening esophagus,A,,17.36,9.24,NA,9.24,,4.36,30.96,30.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014