No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
43107 Esophagectomy Medicare reimbursement rates in Vermont
Reports total or near-total esophageal removal through a cervical approach, with reconstruction using the stomach or jejunum and pyloroplasty when performed. Compare 43107 office and facility rates across CMS payment localities in Vermont.
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 43107 in Vermont?
Vermont 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
$2541.03
1 of 1 localities have a supported rate.
Payment area: Vermont
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 43107: Total esophagectomy, cervical approach
Reports total or near-total esophageal removal through a cervical approach, with reconstruction using the stomach or jejunum and pyloroplasty when performed.
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.
CMS billing rules for 43107
- 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 RVU50.75 · 61%
- Practice expense (office) RVU19.03 · 23%
- Malpractice RVU12.82 · 16%
119
Medicare services in 2024 · #4749 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.
43107 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
43112 describes total or near-total removal through a thoracic approach with stomach or jejunum reconstruction. 43107 is the cervical-approach code.
No office rate
43113 describes a thoracic approach with colon or another substitute for reconstruction. 43107 describes a cervical approach with stomach or jejunum reconstruction.
No office rate
43116 is for partial esophageal removal. 43107 is for total or near-total removal with the specified cervical reconstruction.
Compare 43107 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
Vermont →
Office / nonfacility
Unavailable
Facility
$2541.03
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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 43107 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,118
- Code
- 43107
- Physician work
- 50.75
- Practice expense
- 19.03
- Malpractice
- 12.82
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 50.75 | × 1.000 | 50.7500 |
| Practice expense | 19.03 | × 0.990 | 18.8397 |
| Malpractice | 12.82 | × 0.506 | 6.4869 |
| Total RVUs | 76.0766 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$2541.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 50.75 | 1 |
| Practice expense | 19.03 | 0.99 |
| Malpractice | 12.82 | 0.506 |
(50.75 × 1 + 19.03 × 0.99 + 12.82 × 0.506) × $33.4009 = $2541.03
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.
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 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.
5,1154306F,,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
5,11743101,,Excision of esophagus lesion,A,,16.64,8.17,NA,8.17,,4.19,29.00,29.00,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11843107,,Removal of esophagus,A,,50.75,19.03,NA,19.03,,12.82,82.60,82.60,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,11943108,,Removal of esophagus,A,,80.80,21.57,NA,21.57,,20.37,122.74,122.74,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12043112,,Esphg tot w/thrcm,A,,60.45,20.08,NA,20.08,,15.24,95.77,95.77,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,12143113,,Removal of esophagus,A,,78.06,22.93,NA,22.93,,19.70,120.69,120.69,0,090,0.09,0.81,0.10,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817