No office rate
Both codes describe esophagotomy for foreign-body removal. Choose 43045 for thoracic access and 43020 for cervical access.
On this page
CMS RVU26D · Effective 2026-10-01
43045 Esophagotomy Medicare reimbursement rates in Utah
Open thoracic esophagotomy removes a foreign body from the esophagus when surgical access through the chest is required. Compare 43045 office and facility rates across CMS payment localities in Utah.
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 43045 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1218.25
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
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.
Esophageal surgery
About 43045: Thoracic esophagotomy for foreign body removal
Open thoracic esophagotomy removes a foreign body from the esophagus when surgical access through the chest is required.
This code describes an open operation in which the surgeon reaches the esophagus through the chest, opens it, and removes a foreign body. It is used for cases requiring thoracic surgical access, such as an object lodged in the thoracic esophagus that cannot be managed by an endoscopic approach. A thoracic or general surgeon typically performs the procedure in an operating room, generally in a facility setting.
Select this code when the operative report supports both the thoracic approach and removal of a foreign body; it is distinct from a cervical approach or endoscopic extraction. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. 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 multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43045
- 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 RVU21.33 · 57%
- Practice expense (office) RVU10.98 · 29%
- Malpractice RVU5.37 · 14%
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.
43045 compared with similar codes
Office rates for Utah, from the same CMS release.
$414.62
43215 reports endoscopic esophageal foreign-body removal. Use 43045 when the surgeon opens the esophagus through a thoracic approach.
$406.16
43247 reports foreign-body removal during upper gastrointestinal endoscopy. It is distinct from open thoracic esophagotomy under 43045.
Compare 43045 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.
1 of 1 payment localities
Utah →
Office / nonfacility
Unavailable
Facility
$1218.25
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43045 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,113
- Code
- 43045
- Physician work
- 21.33
- Practice expense
- 10.98
- Malpractice
- 5.37
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.33 | × 1.000 | 21.3300 |
| Practice expense | 10.98 | × 0.940 | 10.3212 |
| Malpractice | 5.37 | × 0.898 | 4.8223 |
| Total RVUs | 36.4735 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$1218.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.33 | 1 |
| Practice expense | 10.98 | 0.94 |
| Malpractice | 5.37 | 0.898 |
(21.33 × 1 + 10.98 × 0.94 + 5.37 × 0.898) × $33.4009 = $1218.25
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
43045 billing questions
When should 43045 be chosen over 43020?
Use 43045 when the surgeon removes the foreign body through a thoracic approach. Code 43020 describes the corresponding cervical approach.
Can endoscopic foreign-body removal be reported as 43045?
No. This code is for open removal through a thoracic esophagotomy. Endoscopic removal is represented by the applicable endoscopy code.
What operative documentation supports 43045?
The report should establish the thoracic surgical approach, an incision into the esophagus, and removal of a foreign body. It should distinguish the procedure from cervical or endoscopic access.
Does 43045 have a 90-day global period?
Yes. The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
Can modifier 50 be used for 43045?
No. Bilateral adjustment is inappropriate for this code.
How are assistant and co-surgeon claims handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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.
5,1104301F,,Pt not rcvng warf thxpy,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11143020,,Incision of esophagus,A,,8.02,6.36,NA,6.36,,2.14,16.52,16.52,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11243030,,Cricopharyngeal myotomy,A,,7.79,4.96,NA,4.96,,1.22,13.97,13.97,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11343045,,Esophagotomy thrc rmvl fb,A,,21.33,10.98,NA,10.98,,5.37,37.68,37.68,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,1144305F,,Pt ed re ft care inspct rcvd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,1154306F,,Pt tlk psych & rx opd addic,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11643100,,Excision of esophagus lesion,A,,9.42,5.93,NA,5.93,,1.36,16.71,16.71,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985