2025 CPT code 43107
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Total or near-total esophagectomy without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal).
Modifiers may be applied as appropriate to reflect variations in service, such as 22 (increased procedural services), 51 (multiple procedures), or 59 (distinct procedural service).Consult the CPT manual for specific indications.
Medical necessity is established by the presence of a resectable esophageal tumor (malignant or benign) or conditions requiring esophageal resection for symptom relief or life preservation.The transhiatal approach is medically necessary when a thoracotomy is contraindicated due to patient comorbidity or other factors.
The surgeon is responsible for all aspects of the procedure, including preoperative assessment, surgical technique, postoperative care, and follow-up.Anesthesiologist and other surgical team members contribute their respective expertise.
- Surgery
- 43107 is part of a larger group of codes (43107-43113, 43286-43288, 43116-43123, 43124) representing various esophagectomy procedures.The distinctions lie in the extent of resection, the use of a thoracotomy, and the type of reconstruction.
In simple words: The surgeon removes most or all of the food pipe (esophagus) and attaches the stomach to the throat or the lower part of the esophagus in the neck. This may involve widening the stomach opening. The chest is not opened during this surgery.
This procedure involves the complete or near-complete removal of the esophagus.The stomach is then reshaped into a tube and connected to either the pharynx (pharyngogastrostomy) or the cervical esophagus (cervical esophagogastrostomy) in the neck.A pyloroplasty, widening of the pyloric sphincter, may also be performed to facilitate food passage.The procedure is performed without a chest incision (transhiatal).
Example 1: A 60-year-old male patient presents with a resectable esophageal adenocarcinoma.A transhiatal esophagectomy with cervical esophagogastrostomy is performed, resulting in the complete removal of the tumor and a successful reconstruction., A 55-year-old female patient experiences a severe esophageal stricture due to caustic ingestion. A transhiatal esophagectomy with pharyngogastrostomy and pyloroplasty is performed to improve food passage., A 72-year-old male patient with a large esophageal tumor is deemed unfit for a thoracotomy. A transhiatal esophagectomy is chosen for its minimally invasive nature and successful removal of the tumor is achieved.
Thorough preoperative assessment, including imaging studies (e.g., CT scan, endoscopy) and pathology reports.Detailed operative notes, including the extent of resection, type of anastomosis, and any complications.Postoperative pathology report confirming tumor-free margins and any complications during the postoperative period.Documentation of medical necessity, including the rationale for the procedure.
** This code encompasses various transhiatal esophagectomy techniques.Always ensure accurate documentation to support the procedure performed.This information is current as of December 3rd, 2024 and may change.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Data not available in source.Consult current Relative Value Units (RVUs) for this CPT code from CMS.
- Global Days: Data not available in source. The global period for this procedure varies depending on the surgeon and payer, usually 90 days.Refer to specific payer guidelines.
- Payment Status: Active
- Modifier TC rule: Data not available in source.The use of a TC (Technical Component) modifier depends on the specific circumstances and payer guidelines.Refer to the payer's specific guidelines.
- Fee Schedule: Data not available in source.Historical fee schedules can be accessed through CMS or other payer websites.
- Specialties:Surgical Oncology, Thoracic Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center