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See a sample rate comparisonCPT 43107 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Total Or Near Total Esophagect, Total Or Near Total Esophagectomy Without Thoracotomy Withpharyngogastrostomy Or Cervical Esophagogastrostomy With Or Without Pyloroplasty (Transhiatal)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | GC - Service performed by resident under supervision 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | $2,758.91 national non-facility rate (2026) · View Medicare rates for 43107 |
| Medicaid Fee Schedule | $2,137.49 median of the 8 states in the free preview · View Medicaid rates for 43107 |
National average reimbursement for CPT 43107 by major payers:
$3,484.85
$3,759.79
$3,944.35
$4,527.00
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CPT 43107
5 of 25 sample ratesHigher to lower in this preview
Inova Loudoun Ambulatory Surgery
$3,931.00Published rateCoral Ridge Outpatient Center LLC, Coral Ridge Outpatient Center
Coral Ridge Outpatient Center, LLC
$1,028.00Published rateGrossmont Outpatient Surgical Center
Grossmont Outpatient Surgical Ce
$649.00Published rateDlv Vision Asc
$450.00Published rateWillow Springs Surgery Center, Ltd, Forest Med-Surg Center
Willow Springs Surgery Center Ltd
$162.00Published rate
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See a sample payer proposalCPT 43107 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43107 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 43107 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 43107-CPT | High | Total Or Near Total Esophagect, Total Or Near Total Esophagectomy Without Thoracotomy Withpharyngogastrostomy Or Cervical Esophagogastrostomy With Or Without Pyloroplasty (Transhiatal) |
| 43108-CPT | High | Removal Of Esophagus, Total Or Near Total Esophagectomy Without Thoracotomy With Colon Interposition Or Small Intestine Reconstruction Including Intestine Mobilization Preparation And Anastomosis Es |
| 43112-CPT | High | Total Or Near Total Esophagectomy With Thoracotomy; With Pharyngogastrostomy Or Cervical Esophagogastrostomy With Or Without Pyloroplasty (Ie Mckeown Esophagectomy Or Tri-Incisional Esophagectomy) (Desc Revised 1/1/2018) |
| 43113-CPT | High | Removal Of Esophagus, Total Or Near Total Esophagectomy With Thoracotomy With Colon Interposition Or Small Intestine Reconstruction Including Intestine Mobilization Preparation And Anastomosis Es |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43107. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43107 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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