Billing code 43300: Esophageal repairMedicare rate & RVUs in Texas
Open cervical repair of an esophageal defect without tracheoesophageal fistula repair, reported when the surgeon repairs the esophagus through a neck approach.
CMS doesn’t publish an office rate for 43300 in Texas.
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 43300 covers
This service involves surgically repairing an esophageal defect through a cervical incision, without repairing a tracheoesophageal fistula. A surgeon may perform it for a cervical esophageal injury or perforation requiring operative closure. The work is generally performed in a hospital operating room by a surgeon experienced in esophageal or upper gastrointestinal surgery; the operative report should identify the cervical approach and the esophageal repair performed.
Report this code when the operative work matches the cervical approach and does not include repair of a tracheoesophageal fistula. Documentation should describe the defect, the repair, the approach, and whether a fistula was repaired. Medicare assigns a 90-day global period, including 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% multiple-procedure reduction. 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.
Where 43300 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $559.18 |
| Beaumont | Unavailable | $530.32 |
| Brazoria | Unavailable | $542.68 |
| Dallas | Unavailable | $547.44 |
| Fort Worth | Unavailable | $545.98 |
| Galveston | Unavailable | $545.20 |
| Houston | Unavailable | $569.37 |
| Rest Of Texas | Unavailable | $537.12 |
How the 43300 rate is calculated
Each of 43300’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 · 43300
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.10Practice expense 6.10Malpractice 1.32
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43300
43300 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43300
Esophageal repair
| 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 · 43300
Esophageal repair
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
43300 without 51 · national facility
$551.78
Esophageal repair
43300-51 · Second procedure: 50%
$275.89
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%).
43300 compared with similar codes
Compare codes
43300 vs 43305 vs 43310 vs 43312: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43305Esophageal repair
- Both use a cervical approach, but 43305 includes repair of a tracheoesophageal fistula; 43300 does not.
- 43310Esophageal repair
- Both describe esophageal repair without fistula repair. Select 43300 for the cervical approach and 43310 for the thoracic approach.
- 43312Esophageal repair
- 43312 is the thoracic-approach repair that includes fistula repair; 43300 is cervical and excludes fistula repair.
43300 billing questions
When should 43300 be chosen over 43305?
Use 43300 for cervical esophageal repair without tracheoesophageal fistula repair. Use 43305 when the surgeon also repairs a fistula through the cervical approach.
How does 43300 differ from 43310?
The approach distinguishes these repairs: 43300 is performed through a cervical approach, while 43310 is the thoracic-approach repair without fistula repair.
What documentation supports reporting 43300?
The operative report should establish the cervical approach, the esophageal defect and its repair, and whether tracheoesophageal fistula repair was performed.
How does Medicare treat other procedures 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. The 90-day global period includes the day-before preoperative visit and related postoperative care.
Can an assistant or co-surgeon be reported for 43300?
Medicare may pay an assistant at surgery. Co-surgeon payment requires supporting documentation, and 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 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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