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See a sample rate comparisonCPT 43124 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 Partial Esophagectomy, Total Or Partial Esophagectomy Without Reconstruction (Any Approach) With Cervical Esophagostomy Total Or Partial Esophagectomy Without Reconstruction (Any
| 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 | 62 - Co-Surgeons 52 - Reduced Services |
| Complexity Level | High |
| Medicare Fee Schedule | $3,553.52 national non-facility rate (2026) · View Medicare rates for 43124 |
| Medicaid Fee Schedule | $2,750.495 median of the 8 states in the free preview · View Medicaid rates for 43124 |
National average reimbursement for CPT 43124 by major payers:
$4,635.74
$4,893.20
$5,210.82
$5,831.97
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CPT 43124
5 of 25 sample ratesHigher to lower in this preview
Palms West Surgery Center Ltd
$2,732.00Published rateWinter Haven Ambulatory Surgical Center LLC
Winter Haven Ambulatory Surgical Center, LLC
$1,049.00Published rateCmmp Surgical Center LLC
Cmmp Surgical Center
$750.00Published rateFront Range Endoscopy Centers, LLC
Front Range Endoscopy Centers LLC
$426.00Published rateZion Ambulatory Center LLC
$48.00Published rate
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See a sample payer proposalCPT 43124 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43124 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 43124 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 |
|---|---|---|
| 43118-CPT | High | Partial Removal Of Esophagus, Partial Esophagectomy Distal Two Thirds With Thoracotomy And Separate Abdominal Incision With Or Without Proximal Gastrectomy With Colon Interposition Or Small Intestine Reconstruction Including Intestine Mobilization Preparation And Anastomosis Es |
| 43123-CPT | High | Partial Removal Of Esophagus, Partial Esophagectomy Thoracoabdominal Or Abdominal Approach With Or Without Proximal Gastrectomy With Colon Interposition Or Small Intestine Reconstruction Including Intestine Mobilization Preparation And Anastomosis Es |
| 43124-CPT | High | Total Or Partial Esophagectomy, Total Or Partial Esophagectomy Without Reconstruction (Any Approach) With Cervical Esophagostomy Total Or Partial Esophagectomy Without Reconstruction (Any |
| 43130-CPT | Moderate | Diverticulctomy Of Hypopharynx Or Esophag W//W/O Myotomy;, Diverticulectomy Of Hypopharynx Or Esophagus With Or Without Myotomy; |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43124. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43124 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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