No office rate
43287 applies to laparoscopic resection of the distal two-thirds of the esophagus. Use 43286 for a total esophagectomy meeting its approach requirements.
On this page
CMS RVU26D · Effective 2026-10-01
43286 Esophagectomy Medicare reimbursement rates in New Jersey
Reports laparoscopic total removal of the esophagus, including thoracic portions, with laparoscopic mobilization of the esophagus and stomach and no thoracotomy. Compare 43286 office and facility rates across CMS payment localities in New Jersey.
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 43286 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$3125.40–$3200.65
2 of 2 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.
Digestive surgery
About 43286: Total laparoscopic esophagectomy
Reports laparoscopic total removal of the esophagus, including thoracic portions, with laparoscopic mobilization of the esophagus and stomach and no thoracotomy.
This service covers total removal of the esophagus using a laparoscopic approach, including laparoscopic mobilization of the esophagus and stomach. It is commonly performed by thoracic or gastrointestinal surgeons in a hospital operating room, often for esophageal cancer requiring resection beyond a distal segment. The code’s scope specifies that the thoracic esophagus is included and that the operation is performed without thoracotomy.
Choose this code when the operative report supports total esophagectomy and the specified laparoscopic approach; a distal two-thirds resection is a different service. Documentation should establish the extent of resection, the approach, and the mobilization performed. The 90-day global period includes 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery payment is not permitted.
CMS billing rules for 43286
- 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 RVU53.63 · 61%
- Practice expense (office) RVU20.84 · 24%
- Malpractice RVU13.71 · 16%
111
Medicare services in 2024 · #4798 by national volume
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.
43286 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
43288 is the related thoracic esophagectomy service with laparoscopic mobilization. Select based on the operation and approach documented, rather than treating it as a total laparoscopic resection.
No office rate
43107 represents an open total or near-total esophagectomy involving thoracotomy. This code is for the specified laparoscopic total esophagectomy performed without thoracotomy.
Compare 43286 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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
Unavailable
Facility
$3200.65
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$3125.40
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43286 billing questions
How do I choose this code instead of 43287?
Use 43286 when the surgeon performs a total esophagectomy by the specified laparoscopic approach. Code 43287 describes resection limited to the distal two-thirds.
Is laparoscopic mobilization separately reported?
The laparoscopic mobilization of the esophagus and stomach is part of this service. It is not separately reported as an additional mobilization procedure.
What documentation supports co-surgeon billing?
The operative record should support the distinct co-surgeon roles and the need for both surgeons. CMS permits co-surgeon payment only with supporting documentation.
Can an assistant surgeon be paid?
Yes. CMS permits assistant-at-surgery payment for this code; the claim and operative documentation should reflect the assistant’s role.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
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.
5,20743283,,Lap esoph lengthening,A,,2.88,0.64,NA,0.64,,0.73,4.25,4.25,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20843284,,Laps esophgl sphnctr agmntj,A,,9.88,6.25,NA,6.25,,2.63,18.76,18.76,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,20943285,,Rmvl esophgl sphnctr dev,A,,10.21,6.33,NA,6.33,,2.73,19.27,19.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21043286,,Esphg tot w/laps moblj,A,,53.63,20.84,NA,20.84,,13.71,88.18,88.18,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21143287,,Esphg dstl 2/3 w/laps moblj,A,,61.43,21.65,NA,21.65,,15.54,98.62,98.62,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21243288,,Esphg thrsc moblj,A,,64.76,22.49,NA,22.49,,16.45,103.70,103.70,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,21343289,,Unlisted laps px esoph,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00