No office rate
Use 43352 for the abdominal approach to esophagotomy and foreign-body removal; 43351 represents the thoracic approach.
On this page
CMS RVU26D · Effective 2026-10-01
43351 Esophagotomy Medicare reimbursement rates in Kentucky
Reports open thoracic access to the esophagus to remove a foreign body when surgical extraction, rather than endoscopic retrieval, is performed. Compare 43351 office and facility rates across CMS payment localities in Kentucky.
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 43351 in Kentucky?
Kentucky 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
$1218.40
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Thoracic surgery
About 43351: Thoracic esophagotomy for foreign body
Reports open thoracic access to the esophagus to remove a foreign body when surgical extraction, rather than endoscopic retrieval, is performed.
CPT 43351 describes an open incision into the esophagus through a thoracic approach to remove a foreign body. A thoracic or general surgeon typically performs the operation in a hospital operating room when surgical access is needed to retrieve an object lodged in the esophagus. The surgeon identifies the object through the operative exposure, removes it through the esophageal opening, and closes the incision.
Select this code when the operative report documents thoracic access and removal of a foreign body; the approach distinguishes it from cervical and abdominal esophagotomy codes. The record should identify the object, its location, the surgical approach, and the extraction performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. An assistant may be paid; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy.
CMS billing rules for 43351
- 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 RVU21.50 · 56%
- Practice expense (office) RVU11.28 · 30%
- Malpractice RVU5.41 · 14%
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.
43351 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$397.23
43215 is flexible transoral endoscopic removal. 43351 is open removal through a thoracic esophageal incision.
Compare 43351 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$1218.40
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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 43351 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
5,239
- Code
- 43351
- Physician work
- 21.50
- Practice expense
- 11.28
- Malpractice
- 5.41
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.50 | × 1.000 | 21.5000 |
| Practice expense | 11.28 | × 0.889 | 10.0279 |
| Malpractice | 5.41 | × 0.915 | 4.9502 |
| Total RVUs | 36.4781 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1218.40
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.5 | 1 |
| Practice expense | 11.28 | 0.889 |
| Malpractice | 5.41 | 0.915 |
(21.5 × 1 + 11.28 × 0.889 + 5.41 × 0.915) × $33.4009 = $1218.40
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.
43351 billing questions
How is 43351 distinguished from 43350 and 43352?
Choose 43351 when the esophageal incision and foreign-body removal use a thoracic approach. Codes 43350 and 43352 represent cervical and abdominal approaches, respectively.
When would 43215 be reported instead?
43215 describes flexible transoral esophagoscopy with foreign-body removal. Use 43351 for open removal through a thoracic esophageal incision, not endoscopic retrieval.
What documentation supports 43351?
Document the foreign body and its esophageal location, the thoracic operative approach, and the removal through an esophageal incision.
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.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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 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.
5,23643338,,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
5,24143360,,Gastrointestinal repair,A,,39.11,14.54,NA,14.54,,9.87,63.52,63.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24243361,,Gastrointestinal repair,A,,44.54,18.60,NA,18.60,,11.94,75.08,75.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631