Choose 43400 for ligation of esophageal veins. Choose 43405 when the operation ligates or staples and transects the esophagus.
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CMS RVU26D · Effective 2026-10-01
43405 Esophageal transection Medicare reimbursement rates in Kansas
Report this code for operative division of the esophagus using ligation or stapling, such as transection performed during surgical treatment of esophageal varices. Compare 43405 office and facility rates across CMS payment localities in Kansas.
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 43405 in Kansas?
Kansas 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
$1263.77
1 of 1 localities have a supported rate.
Payment area: Kansas
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.
Esophageal surgery
About 43405: Esophageal transection by ligation or stapling
Report this code for operative division of the esophagus using ligation or stapling, such as transection performed during surgical treatment of esophageal varices.
This code represents an operation that interrupts the esophagus by ligating or stapling it and dividing the organ. It may be used in surgical management of esophageal varices, where transection is performed as part of an operative strategy to control bleeding. A surgeon performs the procedure in an operating room, generally in a facility setting; Medicare recorded facility services for this code in 2024 and no office services.
Report the code when the operative documentation supports esophageal ligation or stapling with transection, rather than direct ligation of esophageal veins or repair of an injury. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 43405
- 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 RVU24.11 · 57%
- Practice expense (office) RVU11.80 · 28%
- Malpractice RVU6.07 · 14%
27
Medicare services in 2024 · #5739 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.
43405 compared with similar codes
Office rates for Kansas, from the same CMS release.
43410 describes repair of an esophageal wound through a cervical approach; 43405 describes ligation or stapling with esophageal transection.
43415 describes repair of an esophageal wound through a thoracic or abdominal approach. It is not the code for deliberate esophageal transection.
Compare 43405 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1263.77
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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 43405 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
5,244
- Code
- 43405
- Physician work
- 24.11
- Practice expense
- 11.80
- Malpractice
- 6.07
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.11 | × 1.000 | 24.1100 |
| Practice expense | 11.80 | × 0.904 | 10.6672 |
| Malpractice | 6.07 | × 0.504 | 3.0593 |
| Total RVUs | 37.8365 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1263.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.11 | 1 |
| Practice expense | 11.8 | 0.904 |
| Malpractice | 6.07 | 0.504 |
(24.11 × 1 + 11.8 × 0.904 + 6.07 × 0.504) × $33.4009 = $1263.77
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.
43405 billing questions
How does this differ from 43400?
This code describes ligation or stapling with division of the esophagus. Code 43400 is for ligation of esophageal veins, without the esophageal transection described here.
Can this be reported with direct ligation of esophageal veins?
The procedures may be performed during the same operative session for variceal disease. Documentation should identify the distinct esophageal transection and the separate vein-ligation work.
Which global services are included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Medicare may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
How are other procedures in the same session paid?
Medicare pays the highest-valued procedure in full and reduces the other procedures to 50% when multiple procedures are performed in the same session.
What operative documentation supports this code?
The operative report should establish that the esophagus was ligated or stapled and transected. A report describing only vein ligation or repair of an esophageal wound points to a different service.
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.
