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CMS RVU26D · Effective 2026-10-01

43400 Varix ligation Medicare reimbursement rates in Kentucky

Reports surgical ligation of esophageal varices through a thoracic or abdominal approach, rather than endoscopic injection or band treatment. Compare 43400 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 43400 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

$1360.89

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.

Find 43400 in your payment locality →

Esophageal surgery

About 43400: Surgical esophageal varix ligation

Reports surgical ligation of esophageal varices through a thoracic or abdominal approach, rather than endoscopic injection or band treatment.

This operation surgically ligates esophageal varices, typically in a patient with portal hypertension and variceal bleeding. A surgeon reaches the esophagus through a thoracic or abdominal approach to control the varices; this is distinct from treating them through an endoscope. The service is performed in an operative setting, rather than as routine endoscopic management of varices.

Report the code when the operative record supports surgical ligation of the esophageal veins and identifies the approach and treatment performed. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 inappropriate for this single esophageal operation. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 43400

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 RVU24.96 · 59%
  • Practice expense (office) RVU10.89 · 26%
  • Malpractice RVU6.67 · 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.

43400 compared with similar codes

Office rates for Kentucky, from the same CMS release.

43405

Esophageal transection

Ligation or stapling

No office rate

Both are surgical approaches to variceal control. Choose 43400 for surgical ligation of the veins; 43405 describes an esophageal ligation or stapling technique.

43244

Variceal ligation

Esophageal or gastric varices

No office rate

43244 is endoscopic band treatment of esophageal or gastric varices. Use 43400 for surgical ligation through a thoracic or abdominal approach.

43243

Variceal injection

Esophageal or gastric varices

No office rate

43243 reports endoscopic injection treatment of varices. It is not the code for surgical ligation of esophageal veins.

Compare 43400 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

Office and facility base rates · shared scale starting at $0

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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 43400 in Kentucky.

PPRRVU2026_Oct_nonQPP.csv

5,243

Code
43400
Physician work
24.96
Practice expense
10.89
Malpractice
6.67

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Facility calculation for 43400 in Kentucky
ComponentRVULocality factorAdjusted
Physician work24.96× 1.00024.9600
Practice expense10.89× 0.8899.6812
Malpractice6.67× 0.9156.1031
Total RVUs40.7443
Conversion factor× 33.4009

Facility rate, Kentucky$1360.89

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work24.961
Practice expense10.890.889
Malpractice6.670.915

(24.96 × 1 + 10.89 × 0.889 + 6.67 × 0.915) × $33.4009 = $1360.89

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.

43400 billing questions

How is this different from endoscopic variceal banding?

This code is for surgical ligation through a thoracic or abdominal approach. Endoscopic band treatment is reported with the applicable endoscopy code, such as 43244.

What documentation supports reporting this code?

The operative report should identify esophageal varices, the surgical approach, and the ligation performed. Documentation should make clear that treatment was surgical rather than endoscopic.

Can modifier 50 be used for varices on both sides?

No. Modifier 50 is inappropriate for this single esophageal operation.

How does the global period affect postoperative billing?

The code has a 90-day global period. The day-before preoperative visit and related postoperative care during the 90 days are included.

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.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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.

RVUs for 43400PPRRVU2026_Oct_nonQPP.csv, line 5,243 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet