Billing code 43118: Partial esophagectomyMedicare rate & RVUs in Illinois
Reports partial removal of the esophagus through a thoracic approach when continuity is reconstructed with a colon or small-intestinal segment.
CMS doesn’t publish an office rate for 43118 in Illinois.
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 43118 covers
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.
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.
Where 43118 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $4,085.76 |
| East St. Louis | Unavailable | $3,863.07 |
| Rest Of Illinois | Unavailable | $3,610.33 |
| Suburban Chicago | Unavailable | $3,811.33 |
How the 43118 rate is calculated
Each of 43118’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 · 43118
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 65.39Practice expense 18.54Malpractice 16.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43118
43118 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43118
Partial 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) | 2 | Permitted. |
| 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 · 43118
Partial 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
43118 without 51 · national facility
$3,354.12
Partial esophagectomy
43118-51 · Second procedure: 50%
$1,677.06
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%).
43118 compared with similar codes
Compare codes
43118 vs 43117 vs 43122 vs 43107: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43117Partial esophagectomy
- Both are thoracic partial esophagectomy codes. Choose 43118 for reconstruction with colon or small intestine; choose 43117 when the reconstruction is an esophagogastrostomy.
- 43122Esophagectomy
- Both pair partial esophagectomy with intestinal reconstruction, but 43122 is the abdominal-approach code. The documented operative approach distinguishes it from 43118.
- 43107Esophagectomy
- 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.
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 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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