No office rate
This code involves a thoracotomy. Code 43107 describes total or near-total esophageal removal without a thoracotomy.
On this page
CMS RVU26D · Effective 2026-10-01
43124 Esophagectomy Medicare reimbursement rates in Texas
Reports extensive esophageal removal through a thoracotomy, with associated reconstruction, for conditions requiring total or near-total resection. Compare 43124 office and facility rates across CMS payment localities in Texas.
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 43124 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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 43124 pays more and less in Texas
Esophageal surgery
About 43124: Thoracotomy esophagectomy with reconstruction
Reports extensive esophageal removal through a thoracotomy, with associated reconstruction, for conditions requiring total or near-total resection.
This code represents a major operation removing most or all of the esophagus through a chest incision, with the associated gastric resection and reconstruction specified for this procedure. It is typically performed by a thoracic or upper gastrointestinal surgeon in a hospital operating room. Common clinical contexts include esophageal cancer and selected severe benign disease when a limited resection is not appropriate. The operative report should establish the extent of esophageal removal, thoracic approach, stomach resection, and reconstruction performed.
Select this code from the operation actually documented, rather than from the diagnosis alone; distinguish it from partial esophagectomy and from total or near-total resections using a different approach or reconstruction. The procedure has 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% multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 43124
- 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 RVU67.36 · 63%
- Practice expense (office) RVU22.05 · 21%
- Malpractice RVU16.98 · 16%
52
Medicare services in 2024 · #5331 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.
43124 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Code 43117 is for partial esophageal removal. Choose this code when the operative report supports total or near-total resection through a thoracotomy.
No office rate
Both codes are in the total or near-total esophagectomy family. Check the operative report's reconstruction details and the code-specific configuration before choosing between them.
No office rate
Code 43100 addresses excision of an esophageal lesion, not removal of most or all of the esophagus.
Compare 43124 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $3536.08 |
| Beaumont | Office Unavailable | Facility $3446.97 |
| Brazoria | Office Unavailable | Facility $3440.12 |
| Dallas | Office Unavailable | Facility $3490.29 |
| Fort Worth | Office Unavailable | Facility $3490.30 |
| Galveston | Office Unavailable | Facility $3468.82 |
| Houston | Office Unavailable | Facility $3779.61 |
| Rest Of Texas | Office Unavailable | Facility $3460.95 |
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43124 billing questions
How is this code distinguished from a partial esophagectomy?
Use this code when the documented operation removes most or all of the esophagus. A partial esophagectomy code is appropriate when the surgeon removes only a portion.
What operative details support reporting this code?
The report should document the extent of esophageal removal, the thoracotomy, any proximal stomach resection, and the reconstruction. The diagnosis alone does not establish the procedure performed.
Is related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are reduced to 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
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.
5,12543121,,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
5,13143180,,Esophagoscopy rigid trnso,A,,8.80,4.23,NA,4.23,,1.31,14.34,14.34,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00