No office rate
Both codes describe total or near-total esophagectomy with intestinal reconstruction. Use the code that matches the documented operative approach and reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
43113 Esophagectomy Medicare reimbursement rates in Missouri
Reports total or near-total esophageal removal with reconstruction using mobilized intestine, typically during complex surgery for esophageal disease. Compare 43113 office and facility rates across CMS payment localities in Missouri.
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 43113 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$3908.35–$3995.71
3 of 3 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 43113 pays more and less in Missouri
Esophageal surgery
About 43113: Total esophagectomy with intestinal reconstruction
Reports total or near-total esophageal removal with reconstruction using mobilized intestine, typically during complex surgery for esophageal disease.
This code represents removal of most or all of the esophagus with reconstruction using a segment of colon or small intestine that is mobilized to restore continuity. Thoracic or upper gastrointestinal surgeons typically perform the operation in a hospital operating room. Esophagectomy may be used for esophageal cancer or selected severe benign disease when the esophagus cannot be preserved. The operative report should establish the extent of removal and the intestinal reconstruction performed.
Select this service when the documented operation includes total or near-total esophageal removal and intestinal reconstruction, rather than a partial resection or reconstruction using the stomach. The note should identify the tissue removed, the intestinal segment used, and the reconstructive work. 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 procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate for this service.
CMS billing rules for 43113
- 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 RVU78.06 · 65%
- Practice expense (office) RVU22.93 · 19%
- Malpractice RVU19.70 · 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.
43113 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
This code uses intestinal reconstruction; 43107 describes esophagectomy with esophagogastrostomy using the stomach.
No office rate
43117 is for partial esophageal removal with primary repair. This code requires total or near-total removal with intestinal reconstruction.
Compare 43113 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$3969.30
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$3995.71
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$3908.35
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43113 billing questions
How does this differ from a partial esophagectomy?
Use this code for total or near-total esophageal removal with intestinal reconstruction. A partial resection removes only part of the esophagus and is reported with the applicable partial-esophagectomy code.
When is this code preferred over an esophagectomy using the stomach?
This code describes reconstruction using mobilized colon or small intestine. Codes 43107 and 43108 describe esophagectomy with esophagogastrostomy, using the stomach for reconstruction.
What operative documentation supports reporting this service?
The operative report should document total or near-total esophageal removal and reconstruction with a mobilized segment of colon or small intestine. It should also describe the resection and reconstructive work performed.
Is related postoperative care separately reported during the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The code’s global package covers that related care.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeons for this code. Team surgery is not permitted.
Should modifier 50 be used?
No. Bilateral adjustment does not apply, and modifier 50 is inappropriate for this 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.
5,11843107,,Removal of esophagus,A,,50.75,19.03,NA,19.03,,12.82,82.60,82.60,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11943108,,Removal of esophagus,A,,80.80,21.57,NA,21.57,,20.37,122.74,122.74,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12043112,,Esphg tot w/thrcm,A,,60.45,20.08,NA,20.08,,15.24,95.77,95.77,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12143113,,Removal of esophagus,A,,78.06,22.93,NA,22.93,,19.70,120.69,120.69,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12243116,,Partial removal of esophagus,A,,90.67,23.52,NA,23.52,,22.88,137.07,137.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12343117,,Partial removal of esophagus,A,,56.06,20.48,NA,20.48,,14.13,90.67,90.67,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12443118,,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