Billing code 43107: EsophagectomyMedicare rate & RVUs in Utah
Reports total or near-total esophageal removal through a cervical approach, with reconstruction using the stomach or jejunum and pyloroplasty when performed.
CMS doesn’t publish an office rate for 43107 in Utah.
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 43107 covers
This code covers removal of all or nearly all of the esophagus through a cervical approach, followed by reconstruction connecting the remaining esophagus to the stomach or jejunum. Pyloroplasty may also be performed. Thoracic or general surgeons commonly perform this major operation in a hospital for conditions such as esophageal cancer requiring extensive resection and reconstruction.
Report the code when the operative record supports the extent of removal, cervical approach, and specified reconstruction; a limited excision of an esophageal lesion is a different service. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. If multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and applies a 50% reduction to the others. Modifier 50 is inappropriate for this single-organ procedure. Assistant-at-surgery services 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.
43107 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $2,677.10 |
How the 43107 rate is calculated
Each of 43107’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 · 43107
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 50.75Practice expense 19.03Malpractice 12.82
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43107
43107 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43107
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) | 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 · 43107
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
43107 without 51 · national facility
$2,758.91
Esophagectomy
43107-51 · Second procedure: 50%
$1,379.46
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%).
43107 compared with similar codes
Compare codes
43107 vs 43108 vs 43112 vs 43113 vs 43116: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43108Esophagectomy
- Both describe total or near-total removal through a cervical approach. Choose 43108 when reconstruction uses colon or another substitute rather than the stomach or jejunum.
- 43112Esophagectomy
- 43112 describes total or near-total removal through a thoracic approach with stomach or jejunum reconstruction. 43107 is the cervical-approach code.
- 43113Esophagectomy
- 43113 describes a thoracic approach with colon or another substitute for reconstruction. 43107 describes a cervical approach with stomach or jejunum reconstruction.
- 43116Esophagectomy
- 43116 is for partial esophageal removal. 43107 is for total or near-total removal with the specified cervical reconstruction.
43107 billing questions
How does 43107 differ from 43108?
43107 describes reconstruction using the stomach or jejunum. 43108 is the related option when the reconstruction uses colon or another substitute.
When should 43112 be considered instead?
43112 describes total or near-total removal with a thoracic approach. Use 43107 when the documented approach is cervical and the reconstruction is with the stomach or jejunum.
Is pyloroplasty separately represented by this code?
Pyloroplasty may be part of the operation described by 43107. The code includes the option of performing it with the esophagectomy.
Can modifier 50 be used for 43107?
No. The esophagus is a single midline organ, and bilateral adjustment is inappropriate for this procedure.
What postoperative care is included?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. 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 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
Fee sheets
Put 43107 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →