No office rate
Both involve partial thoracic esophagectomy and a bowel conduit; distinguish them by the location of the conduit connection, cervical for 43123 versus intrathoracic for 43121.
On this page
CMS RVU26D · Effective 2026-10-01
43123 Esophagectomy Medicare reimbursement rates in Minnesota
Reports thoracic partial esophagectomy reconstructed with a colon or jejunal conduit and connected to the cervical esophagus. Compare 43123 office and facility rates across CMS payment localities in Minnesota.
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 43123 in Minnesota?
Minnesota 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
$3717.36
1 of 1 localities have a supported rate.
Payment area: Minnesota
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 43123: Thoracic partial esophagectomy with bowel conduit
Reports thoracic partial esophagectomy reconstructed with a colon or jejunal conduit and connected to the cervical esophagus.
This operation removes a portion of the thoracic esophagus and restores the passage using a segment of colon or jejunum connected to the cervical esophagus. A surgeon performs it in an operating room, commonly for esophageal disease that requires segmental removal and reconstruction rather than removal of a small isolated lesion. The operative report should establish the resection site and extent, the bowel conduit used, and the location of the connection.
Select this code when the documented operation matches that resection and reconstruction, not merely because part of the esophagus was removed. The operative report should describe the conduit and cervical connection; a different reconstruction or a limited lesion excision points to a different code. Medicare treats the service as major surgery with 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, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43123
- 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 RVU81.04 · 65%
- Practice expense (office) RVU23.52 · 19%
- Malpractice RVU20.45 · 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.
43123 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
43117 involves partial thoracic esophagectomy with primary repair. Use 43123 when the reconstruction uses a colon or jejunal conduit connected to the cervical esophagus.
No office rate
43118 uses gastric reconstruction after partial thoracic esophagectomy. 43123 describes reconstruction with a colon or jejunal conduit and a cervical connection.
No office rate
43100 is for excision of an esophageal lesion, not the thoracic segmental resection and bowel-conduit reconstruction represented by 43123.
Compare 43123 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
Minnesota →
Office / nonfacility
Unavailable
Facility
$3717.36
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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 43123 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
5,127
- Code
- 43123
- Physician work
- 81.04
- Practice expense
- 23.52
- Malpractice
- 20.45
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 81.04 | × 1.000 | 81.0400 |
| Practice expense | 23.52 | × 1.029 | 24.2021 |
| Malpractice | 20.45 | × 0.296 | 6.0532 |
| Total RVUs | 111.2953 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$3717.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 81.04 | 1 |
| Practice expense | 23.52 | 1.029 |
| Malpractice | 20.45 | 0.296 |
(81.04 × 1 + 23.52 × 1.029 + 20.45 × 0.296) × $33.4009 = $3717.36
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.
43123 billing questions
How is this code distinguished from 43121?
The key distinction is where the bowel conduit connects: 43123 describes a cervical connection, while 43121 describes an intrathoracic connection. Check the operative report for the anastomosis location.
Can a separate code be reported for the bowel conduit reconstruction?
The conduit reconstruction is part of the operation described by this code. The operative report should support the esophageal resection, conduit, and cervical connection.
Does this code have a 90-day global period?
Yes. The day-before preoperative visit and related postoperative care during the 90-day period are included.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
Should modifier 50 be used?
No. The anatomy and procedure are not suited to bilateral reporting, so modifier 50 is inappropriate.
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.
5,12443118,,Partial removal of esophagus,A,,65.39,18.54,NA,18.54,,16.49,100.42,100.42,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12543121,,Partial removal of esophagus,A,,50.14,17.40,NA,17.40,,12.66,80.20,80.20,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12643122,,Partial removal of esophagus,A,,43.08,16.00,NA,16.00,,10.87,69.95,69.95,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12743123,,Partial removal of esophagus,A,,81.04,23.52,NA,23.52,,20.45,125.01,125.01,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12843124,,Removal of esophagus,A,,67.36,22.05,NA,22.05,,16.98,106.39,106.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12943130,,Removal of esophagus pouch,A,,12.22,6.95,NA,6.95,,2.22,21.39,21.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,13043135,,Removal of esophagus pouch,A,,25.52,9.62,NA,9.62,,6.43,41.57,41.57,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002