Billing code 43400: Varix ligationMedicare rate & RVUs in Nevada
Reports surgical ligation of esophageal varices through a thoracic or abdominal approach, rather than endoscopic injection or band treatment.
CMS doesn’t publish an office rate for 43400 in Nevada.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 43400 covers
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.
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 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,383.37 |
How the 43400 rate is calculated
Each of 43400’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43400
RVUs × geographic indexes × conversion factor
Work24.96
24.96 RVUs× 1.000 GPCI
Practice expense10.89
10.89 RVUs× 1.000 GPCI
Malpractice6.67
6.67 RVUs× 1.000 GPCI
Adjusted RVUs
42.5200
Conversion factor
$33.4009
Medicare rate
$1,420.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43400
43400 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43400
Varix ligation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43400
Varix ligation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43400 without 51 · national facility
$1,420.21
Varix ligation
43400-51 · Second procedure: 50%
$710.11
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43400 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43405Esophageal transection
- Both are surgical approaches to variceal control. Choose 43400 for surgical ligation of the veins; 43405 describes an esophageal ligation or stapling technique.
- 43244Variceal ligation
- 43244 is endoscopic band treatment of esophageal or gastric varices. Use 43400 for surgical ligation through a thoracic or abdominal approach.
- 43243Variceal injection
- 43243 reports endoscopic injection treatment of varices. It is not the code for surgical ligation of esophageal veins.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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