Billing code 43113: EsophagectomyMedicare rate & RVUs in Oregon
Reports total or near-total esophageal removal with reconstruction using mobilized intestine, typically during complex surgery for esophageal disease.
CMS doesn’t publish an office rate for 43113 in Oregon.
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 43113 covers
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.
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.
Where 43113 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $3,989.44 |
| Rest Of Oregon | Unavailable | $3,832.67 |
How the 43113 rate is calculated
Each of 43113’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 · 43113
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 78.06Practice expense 22.93Malpractice 19.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43113
43113 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43113
Esophagectomy
| 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) | 2 | Permitted. |
| 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 · 43113
Esophagectomy
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
43113 without 51 · national facility
$4,031.15
Esophagectomy
43113-51 · Second procedure: 50%
$2,015.58
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%).
43113 compared with similar codes
Compare codes
43113 vs 43112 vs 43107 vs 43117: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43112Esophagectomy
- Both codes describe total or near-total esophagectomy with intestinal reconstruction. Use the code that matches the documented operative approach and reconstruction.
- 43107Esophagectomy
- This code uses intestinal reconstruction; 43107 describes esophagectomy with esophagogastrostomy using the stomach.
- 43117Partial esophagectomy
- 43117 is for partial esophageal removal with primary repair. This code requires total or near-total removal with intestinal reconstruction.
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 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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