2025 CPT code 43100
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Excision of a lesion from the esophagus with primary repair through a cervical approach.
Modifiers may be applicable depending on the circumstances.Consult the CPT manual for a comprehensive list of modifiers and their usage guidelines.For example, modifier 22 (Increased Procedural Services) might be applied if the procedure is significantly more complex than usual.
Medical necessity for this procedure is established by the presence of a lesion in the cervical esophagus that requires surgical excision for either diagnostic or therapeutic reasons.The lesion should be documented in the medical record, and the need for surgical intervention should be clearly justified.
The surgeon is responsible for all aspects of the procedure, including patient preparation, incision, tissue dissection, lesion excision, esophageal repair, and wound closure.
In simple words: The doctor makes a cut in the neck to remove a damaged or diseased area of the food pipe (esophagus).The food pipe is then repaired with stitches, and the skin incision is closed.
This procedure involves making an incision in the neck to access and remove a lesion from the esophagus.The surgeon carefully dissects the tissues to reach the esophagus, identifies and inspects the lesion, and excises it using a scalpel.The esophageal layers are repaired using sutures, the esophageal borders are closed, and the skin incision is closed.This approach is used when the lesion is accessible through the neck.
Example 1: A patient presents with a benign esophageal polyp located in the cervical esophagus. The surgeon performs a cervical esophagotomy to remove the polyp and performs primary repair., A patient with a small esophageal carcinoma located in the cervical esophagus undergoes surgical removal with primary repair. The surgeon performs a cervical esophagotomy., A patient develops a stricture in the cervical esophagus due to a previous injury.The surgeon excises the stricture and repairs the esophagus via a cervical approach.
Complete surgical history, including indication for surgery, preoperative imaging (e.g., endoscopy, barium swallow), intraoperative findings, pathology report confirming the nature of the lesion, details of the surgical technique, and postoperative recovery notes.
** This code is for excision of a lesion from the esophagus with primary repair via cervical approach.The size and nature of the lesion, as well as any associated complications, may affect the complexity and time required for the procedure.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: The RVUs for this code will vary based on geographic location, facility type, and other factors. Consult the appropriate fee schedule for specific values.
- Global Days: The global period for this procedure will depend on the complexity and extent of the surgery.Additional information should be sourced from your local Medicare Administrative Contractor (MAC) or other payer guidelines.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applied to this code, as it represents a complete surgical procedure. The entire procedure is usually performed by the surgeon.
- Fee Schedule: Historical fee schedule data can be obtained from the CMS website or other relevant payer databases.These data will vary by year and location.
- Specialties:General Surgery, Thoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Office