CPT 43107
Global 090 ActiveRemoval of esophagus
CPT 43107 Billing & Documentation Guide
CPT code 43107 (Removal of esophagus) is classified under Surgery (Digestive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 50.75, a non-facility practice expense RVU of 19.03, and a malpractice RVU of 12.82, a total non-facility RVU of 82.6 and facility RVU of 82.6. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2759.6, though rates vary from $2435.9 to $3455.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 43107, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 43107 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 43107 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 43107
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 50.75 | 50.75 |
| Practice Expense RVU | 19.03 | 19.03 |
| Malpractice RVU | 12.82 | 12.82 |
| Total RVU | 82.6 | 82.6 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 43107
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $2740.17 | $2740.17 | $2650.07 - $3027.63 | 29 |
| Florida | $3166.39 | $3166.39 | $2946.33 - $3439.69 | 3 |
| Georgia | $2816.36 | $2816.36 | $2772.48 - $2860.24 | 2 |
| Illinois | $3133.49 | $3133.49 | $2944.69 - $3328.48 | 4 |
| Michigan | $2894.63 | $2894.63 | $2758.85 - $3030.41 | 2 |
| North Carolina | $2561.75 | $2561.75 | $2561.75 - $2561.75 | 1 |
| New York | $3066.72 | $3066.72 | $2599.96 - $3354.5 | 5 |
| Ohio | $2707.04 | $2707.04 | $2707.04 - $2707.04 | 1 |
| Pennsylvania | $2790.69 | $2790.69 | $2683.24 - $2898.13 | 2 |
| Texas | $2727.93 | $2727.93 | $2671.31 - $2929.03 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 43107
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 43107 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 43107
What does CPT code 43107 mean? +
CPT code 43107 represents: Removal of esophagus. It's in the Surgery (Digestive) category with a global period of 090.
What is the Medicare reimbursement for CPT 43107? +
The 2026 Medicare national average non-facility payment for CPT 43107 is $2759.6. Rates range from $2435.9 to $3455.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 43107? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 43107? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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