No office rate
Both use an approach without thoracotomy for extensive esophageal removal. The distinguishing factor is reconstruction: 43108 uses a substitute conduit, while 43107 uses the stomach.
On this page
CMS RVU26D · Effective 2026-10-01
43108 Esophagectomy Medicare reimbursement rates in Vermont
Reports removal of nearly all or all of the esophagus without thoracotomy when reconstruction uses a colon segment or another substitute conduit. Compare 43108 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 43108 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
$3756.32
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.
Thoracic surgery
About 43108: Total esophagectomy with substitute conduit
Reports removal of nearly all or all of the esophagus without thoracotomy when reconstruction uses a colon segment or another substitute conduit.
This operation removes nearly all or all of the esophagus through an approach that does not use a thoracotomy, then restores continuity with a colon segment or another substitute conduit. It is typically performed by a thoracic or general surgeon in an operating room for conditions requiring extensive esophageal removal, such as esophageal cancer or severe benign disease. The operative report should establish the extent of removal, the approach, and the reconstructive conduit used.
The reconstruction is part of the reported service; distinguish this code from a similar operation using the stomach for reconstruction and from esophagectomy performed with thoracotomy. 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 43108
- 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 RVU80.80 · 66%
- Practice expense (office) RVU21.57 · 18%
- Malpractice RVU20.37 · 17%
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.
43108 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Both involve extensive removal with substitute-conduit reconstruction. Report 43113 when thoracotomy is used; 43108 describes the operation without thoracotomy.
No office rate
43112 describes extensive removal with thoracotomy and stomach-based reconstruction. This code describes no thoracotomy and reconstruction with a substitute conduit.
No office rate
43116 is a partial-removal option. This code is for removal of nearly all or all of the esophagus with substitute-conduit reconstruction.
Compare 43108 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
$3756.32
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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 43108 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,119
- Code
- 43108
- Physician work
- 80.80
- Practice expense
- 21.57
- Malpractice
- 20.37
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 80.80 | × 1.000 | 80.8000 |
| Practice expense | 21.57 | × 0.990 | 21.3543 |
| Malpractice | 20.37 | × 0.506 | 10.3072 |
| Total RVUs | 112.4615 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$3756.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 80.8 | 1 |
| Practice expense | 21.57 | 0.99 |
| Malpractice | 20.37 | 0.506 |
(80.8 × 1 + 21.57 × 0.99 + 20.37 × 0.506) × $33.4009 = $3756.32
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.
43108 billing questions
How does this differ from 43107?
Both describe extensive esophageal removal without thoracotomy. Choose 43108 when reconstruction uses a colon segment or another substitute conduit; 43107 describes reconstruction using the stomach.
Is the conduit reconstruction separately reported?
The substitute-conduit reconstruction is included in this esophagectomy service. The operative documentation should identify the conduit used.
When is 43113 a better match?
43113 describes the corresponding extensive removal and substitute-conduit reconstruction when the operation includes thoracotomy. This code is for the approach without thoracotomy.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What payment rules apply when other 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. The service has a 90-day global period; assistant-at-surgery payment may be made, co-surgeons require 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 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.
5,11643100,,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
5,12243116,,Partial removal of esophagus,A,,90.67,23.52,NA,23.52,,22.88,137.07,137.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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