No office rate
43286 is designated for total esophagectomy. Choose between the codes by matching the operative report to the full procedure definition, not by approach alone.
On this page
CMS RVU26D · Effective 2026-10-01
43288 Esophagectomy Medicare reimbursement rates in Illinois
Reports thoracoscopic esophageal resection with laparoscopic stomach mobilization for reconstruction, when the operative service matches this code’s defined procedure. Compare 43288 office and facility rates across CMS payment localities in Illinois.
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 43288 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$3707.66–$4194.10
4 of 4 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 43288 pays more and less in Illinois
Esophageal surgery
About 43288: Thoracoscopic esophagectomy with gastric mobilization
Reports thoracoscopic esophageal resection with laparoscopic stomach mobilization for reconstruction, when the operative service matches this code’s defined procedure.
This code describes an esophagectomy performed through a thoracoscopic approach, with laparoscopic mobilization of the stomach for reconstruction. Thoracic and upper gastrointestinal surgeons typically perform the operation in a hospital operating room for conditions such as esophageal cancer or severe esophageal disease requiring resection. The operative report should identify the approach, resection performed, gastric mobilization, and reconstruction details so the service can be distinguished from other esophagectomy techniques.
Report the code when the documented operation matches its specific procedure definition; do not select it from the thoracoscopic approach alone. Medicare assigns 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 is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made, and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 43288
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU64.76 · 62%
- Practice expense (office) RVU22.49 · 22%
- Malpractice RVU16.45 · 16%
202
Medicare services in 2024 · #4319 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.
43288 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
43287 is designated for distal two-thirds esophagectomy. The documented resection must support that specific extent to use it.
43289
No office rateUnlisted laps px esoph
43289 is an unlisted laparoscopic esophageal procedure. Use 43288 when its listed thoracoscopic operation with laparoscopic stomach mobilization matches the documented service.
Compare 43288 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$4194.10
East St. Louis →
Office / nonfacility
Unavailable
Facility
$3960.72
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$3707.66
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$3923.27
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43288 billing questions
How does this differ from 43286 or 43287?
Those sibling codes specify total esophagectomy and distal two-thirds esophagectomy, respectively. Use the code whose full procedure definition matches the resection documented in the operative report.
Does thoracoscopic access alone support 43288?
No. The service also involves laparoscopic stomach mobilization, and the complete operation must match this code’s procedure definition.
Can assistant-at-surgery or co-surgeon claims be reported?
Medicare may pay an assistant at surgery, and co-surgeons are permitted. Team surgery is not permitted for this code.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Should modifier 50 be appended?
No. Bilateral adjustment does not apply, and modifier 50 is inappropriate for this procedure.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others.
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.
5,20943285,,Rmvl esophgl sphnctr dev,A,,10.21,6.33,NA,6.33,,2.73,19.27,19.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21043286,,Esphg tot w/laps moblj,A,,53.63,20.84,NA,20.84,,13.71,88.18,88.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21143287,,Esphg dstl 2/3 w/laps moblj,A,,61.43,21.65,NA,21.65,,15.54,98.62,98.62,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21243288,,Esphg thrsc moblj,A,,64.76,22.49,NA,22.49,,16.45,103.70,103.70,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21343289,,Unlisted laps px esoph,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,2144328F,,Pt asked re sleep disturb,I,,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
5,21543290,,Egd flx trnsorl dplmnt balo,A,,3.03,76.51,,1.32,,0.36,79.90,4.71,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00