43122

Partial removal of esophagus

Add to my model
Code typePrimary
Payment statusActive (A)
Global period90-day

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary43122Partial removal of esophagus
1
$2,336.39
$2,336.39
Add-on32674Thoracoscopy lymph node exc
0
$195.40/ unit
$195.40/ unit
Add-on38746Remove thoracic lymph nodes
0
$195.40/ unit
$195.40/ unit
Whole procedure · 43.08 wRVU credited
$2,336.39
$2,336.39

RVU Breakdown

Component
Office
Facility
Work
43.08
43.08
Practice expense
16.00
16.00
Malpractice
10.87
10.87
Total RVU
69.95
69.95

Payment Policy & Modifiers

Allowed adjustments
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%. Add-on codes are exempt.
Assistant surgeon -80/81/8216%
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons -6262.5% each
Co-surgeons paid (62.5% each) if medical necessity is documented.
Not applicable to this code
Bilateral -50Team surgeon -66Prof / tech split

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 9% is attributed to pre-operative care, 81% to the procedure itself, and 10% to post-operative visits.